薛立斋治少参王阳湖孙,八岁伤股,骨正体斜。视其面,青而兼黄,口角微动,此肝木侮脾土故也。且气
血筋骨,皆资脾土而生,但壮脾气,则所伤自愈。遂用六君子汤加钩藤、当归,三十余剂,诸症悉愈。
义兴杨纯父幼儿,病寒热,势甚危,诸医以为伤寒也,药之不效。仲淳曰∶此必内伤。纯父不信,遍询乳
媪及左右,并不知所以伤故。仲淳固问不已,偶一负薪者自外至,闻而讶曰∶曩见郎君攀竹稍为戏,稍折坠地,
伤或在此乎?仲淳曰∶信矣。投以活血导滞之剂,数服而起。仲淳尝言,古先望闻问而后切,良有深意,人以
多问嘲医,医者含糊诊之,以致两误,悲矣。(《广笔记》。)
一小儿五岁,因自戏剧,以茎入捣药臼中,不复出,举家惊呼无计。或教之使执儿两足,以新汲水急浇之,
惊啼体缩,遂得出。
张景岳长男,甫二周而患背疽。初起时,背中忽见微肿,数日后,按之则根深渐阔,其大如杯,皮色不变,
亦不甚痛。至十余日,身有微热,其势滋甚,乃谋之疡医。或云背疽,或云痰气,或曰荤腥,温补毫不可入
口,乃以解毒之药投之,而身反大热,神气愈困,饮食不进。因思丹溪有云∶痈疽因积毒在脏腑,当先助胃气
为主,使根本坚固,而以行经活血佐之。又曰∶但见肿痛,参之脉症,虚弱便与滋补,气血无亏,可保终身,
是诚确论也。(全书中何以大非薄之?)因却前医,而专固元气,以内托其毒,遂用人参三钱,制附子一钱,
佐以当归、熟地、炙草、肉桂之属,一剂而饮食顿进,再剂而神采如旧,抑何神也。由是弛其口腹,药食并进,
十剂而脓成。以其根深皮浓,复用针出脓甚多,调理月余而愈。大凡肿疡溃疡,虚症未见,但无实热壅滞
可据者,便宜托补如此。
张子和治一富家女子,十余岁,好食紫樱,每食即二三斤,岁岁如此,至十余年。一日,潮热如劳,诊其
两手尺脉,皆洪大而有力,谓之曰∶他日必作恶疮肿毒,热气上攻,乃阳盛阴脱之症。其家大怒,不肯服解毒
之药。不二三年,患一背疽如盘,痛不可忍。其女忽思张曾有是言,再三悔过请张。张以排针绕疽晕,刺数百
针,去血一斗,如此三次,渐渐痛减肿消,微出脓而敛。将作痂时,使服十剂内托散乃痊。痊后终身忌口,然
目亦昏,终身无子。
薛立斋诊治少参王阳湖的孙子,八岁时大腿受伤,骨骼位置正常但身体姿态倾斜。观察他的面色,青中兼黄,口角微微抽动,这是肝木克制脾土的表现。况且气、血、筋、骨,都依赖脾土的滋养而生,只要强壮脾气,所受的伤自然会痊愈。于是使用六君子汤(由人参、白术、茯苓、甘草、陈皮、半夏组成)加入钩藤、当归,服用三十多剂后,各种症状全部痊愈。
义兴人杨纯父的幼儿,患病出现寒热往来,病情非常危急,各位医生认为是伤寒,用药后没有效果。张景岳(字仲淳)说:“这一定是内伤。”杨纯父不相信,遍询乳母及身边的人,都不知道受伤的原因。张景岳坚持询问不止,偶然有一个背柴的人从外面进来,听到后惊讶地说:“以前看见郎君攀爬竹梢玩耍,竹梢折断摔在地上,伤或许就在这里吧?”张景岳说:“确实如此。”给他投用活血导滞的药剂,服用几服后病就好了。张景岳曾经说,古人先望诊、闻诊、问诊而后切诊,其中确有深意。人们因为多问而嘲笑医生,医生含糊其辞地诊断,导致两次误诊,真是可悲啊。(出自《广笔记》。)
一个五岁的小儿,因为嬉戏玩耍,将阴茎插入捣药的臼中,拔不出来,全家惊呼没有办法。有人教他们抓住孩子的两脚,用新打的井水急速浇淋,孩子因惊吓啼哭身体收缩,于是阴茎就出来了。
张景岳的大儿子,刚满两周岁时患背疽。初起时,背部忽然出现轻微肿胀,几天后,按压下去感觉根深且逐渐变宽,大小如杯子,皮肤颜色不变,也不怎么疼痛。到了十多天,身上有微热,病情更加严重,于是咨询外科医生。有人说背疽,有人说痰气,有人说荤腥食物所致,认为温补类药物绝对不可入口,于是投用解毒的药物,结果身体反而大热,精神气息更加困倦,饮食不进。于是想起朱丹溪说过:“痈疽是因为积毒在脏腑,应当先以助胃气为主,使根本坚固,再配合行经活血的药物辅助。”又说:“只要见到肿痛,参考脉象和症状,如果虚弱就给予滋补,气血不亏损,可以保全终身,这确实是确切的论断。”(为什么全书中大加非薄朱丹溪呢?)于是拒绝前医的治疗,专门固护元气,以内托法排出毒素,于是用人参三钱,制附子一钱,佐以当归、熟地黄、炙甘草、肉桂等药物,服用一剂后饮食突然增进,服用两剂后神采恢复如旧,多么神奇啊。从此放宽饮食禁忌,药食并进,十剂后脓液形成。因为其根深皮厚,又用针放出很多脓液,调理一个多月后痊愈。大凡肿疡溃疡,如果没有看到虚证表现,只要没有实热壅滞可依据的,就适宜这样托补。
张子和治疗一个富家女子,十几岁,喜欢吃紫樱桃,每次吃两三斤,年复一年,持续了十多年。一天,出现潮热像劳损的样子,诊察她的两手尺脉,都洪大而有力,对她说:“日后必定会发作恶疮肿毒,热气上攻,这是阳盛阴脱的症状。”她家人大怒,不肯服用解毒的药物。不到两三年,背上生了一个如盘子大的背疽,疼痛难以忍受。那女子忽然想起张子和曾有此言,再三悔过请求张子和诊治。张子和用排针围绕疽的边缘,刺了几百针,放血一斗,如此三次,渐渐疼痛减轻肿胀消退,微微出脓而收敛。将要结痂时,让她服用十剂内托散才痊愈。痊愈后终身忌口,然而眼睛也昏花,终身无子。
Dr. Xue Lizhai treated the grandson of Vice Minister Wang Yanghu, who was eight years old and had suffered a thigh injury. The bone structure was normal, but his posture was slanted. Observing his complexion, it was cyanotic with a yellowish tint, and the corners of his mouth twitched slightly. This indicated that Liver Wood (Liver system) was overacting on Spleen Earth (Spleen system). Furthermore, Qi, Blood, sinews, and bones all rely on Spleen Earth for nourishment and generation. By strengthening Spleen Qi, the injury would heal itself. Thus, he prescribed Liu Jun Zi Tang (Six Gentlemen Decoction) added with Gouteng (Uncaria Rhynchophylla) and Danggui (Angelica Sinensis). After taking more than thirty doses, all symptoms completely resolved.
The young son of Yang Chunfu from Yixing fell ill with alternating chills and fever, in a critical condition. Various physicians diagnosed it as Shanghan (Cold Damage), but the medication proved ineffective. Zhang Jingyue (courtesy name Zhongchun) stated, "This must be an internal injury." Mr. Yang did not believe this and questioned the wet nurse and attendants extensively, but no one knew the cause of the injury. Dr. Zhang insisted on asking further. Suddenly, a woodcarrer returning from outside heard this and exclaimed, "I previously saw the young master playing by climbing bamboo tips; when a tip broke, he fell to the ground. Could the injury be there?" Dr. Zhang said, "It is indeed so." He administered a formula promoting blood circulation and guiding out stagnation. After a few doses, the child recovered. Dr. Zhang often remarked that the ancients prioritized observation (Wang), listening/smelling (Wen), and inquiry (Wen) before palpation (Qie), which held profound significance. It is tragic that people mock doctors for asking too many questions, leading physicians to diagnose vaguely, resulting in double misdiagnosis. (From *Guang Biji*.)
A five-year-old boy, while playing, inserted his penis into a mortar used for pounding herbs and could not withdraw it. His family panicked without knowing what to do. Someone advised them to hold the child's two feet and pour newly drawn well water rapidly over him. Due to the cold shock, the child cried and his body contracted, allowing the penis to emerge.
Zhang Jingyue's eldest son developed a carbuncle on the back at just two weeks old. Initially, a slight swelling appeared on the back. After several days, pressing it revealed a deep root that gradually widened, becoming as large as a cup. The skin color remained unchanged, and there was little pain. After ten-plus days, he developed a slight fever, and the condition worsened. They consulted a surgeon. Some diagnosed it as a back carbuncle, others as phlegm-qi disorder, or attributed it to dietary indiscretion with meat/fish. They asserted that warming and tonifying medicines were absolutely contraindicated. Consequently, detoxifying herbs were administered, but the body became extremely hot, spirit and qi grew more exhausted, and food intake ceased. Recalling Zhu Danxi's words: "Carbuncles and ulcers are caused by accumulated toxins in the zang-fu organs; one must first assist Stomach Qi to solidify the foundation, then assist with herbs that promote meridian circulation and invigorate blood." Zhu also stated: "Whenever swelling and pain are seen, if pulse and symptoms indicate deficiency, provide tonification. If Qi and Blood are not depleted, lifelong health can be preserved." This was indeed a precise theory. (Why does the *Complete Works* heavily criticize Zhu Danxi?) Thus, rejecting previous treatments, Zhang focused on consolidating Yuan Qi and using the Internal Support method to expel toxins. He used Renshen (Ginseng Root) 3 qian, Zhi Fuzi (Prepared Aconite Lateral Root) 1 qian, assisted with Danggui (Angelica Sinensis), Shudi (Prepared Rehmannia Root), Zhi Cao (Honey-fried Licorice Root), Rougui (Cinnamon Bark), etc. After one dose, appetite suddenly improved; after two doses, vitality returned to normal. How miraculous! From then on, dietary restrictions were relaxed, combining medicine and food. After ten doses, pus formed. Because the root was deep and the skin thick, needles were used to drain much pus. After over a month of conditioning, he recovered. Generally, for abscesses or ulcers, if no deficiency signs are evident, and no excess heat stagnation is present, such supportive tonification is appropriate.
Zhang Hezi treated a wealthy girl in her teens who loved eating purple cherries, consuming two to three jin each time, year after year, for over ten years. One day, she experienced tidal fever resembling consumption. Palpating both Chi pulses (Kidney pulses) at the wrists, they were surging and forceful. He told her, "In the future, you will certainly develop malignant sores and toxic swellings due to heat qi attacking upward. This is a syndrome of Excess Yang and Deficient Yin." Her family was furious and refused to take detoxifying herbs. Within two to three years, she developed a back carbuncle the size of a plate, unbearable in pain. The girl suddenly remembered Zhang's prediction, repented, and repeatedly requested his treatment. Zhang surrounded the carbuncle margin with a row of needles, inserting hundreds of needles, draining one dou of blood. He repeated this three times. Gradually, pain decreased and swelling subsided, with slight pus discharge leading to contraction. When scabbing was about to form, he prescribed ten doses of Neituo San (Internal Support Powder) until she recovered. After recovery, she observed lifelong dietary taboos, yet her vision dimmed, and she remained childless for life.