渔庄沈 秋暑内逼,腹痛如绞,大便赤不爽,脉弦濡,舌赤,呕恶,防痢。(七月二十四
日。)
藿香(钱半) 红藤(钱半) 炒银花(三钱) 仙半夏(钱半) 左金丸(八分) 广郁金(三
钱) 滑石(四钱) 莱菔子(三钱) 省头草(三钱) 川朴(一钱) 枳壳(钱半)
清煎二帖。
介按∶暑热内逼肝经,阻碍气机,扰乱肠胃,因而腹中绞痛。治以平肝清热,理气止痛
,方法甚佳。
渔庄沈 腹痛已除,胃气较振,脉两手皆弦,肝横气滞,阴火不敛。姑宜养胃泄肝。(
八月初三日。)
黄草斛(三钱) 左金丸(八分) 焦栀子(三钱) 川楝子(三钱) 生石决明(六钱) 白芍
(钱
半) 广郁金(三钱) 佛手花(八分) 丹皮(三钱) 枳壳(钱半) 木蝴蝶(四分) (引)路路
通(七枚)
二帖。
介按∶此系腹痛少减,肝热未清,胃阴未复之症。
安昌沈 闺女腹痛欲呕,脉寸弦滑,此由寒温失调,夹食为患,咳逆。宜开提和中,防
变。(九月二十二日。)
桔梗(钱半) 枳壳(钱半) 省头草(三钱) 青木香(七分) 山楂(四钱) 前胡(钱半)
原郁金(三钱) 光杏仁(三钱) 红藤(钱半) 藿香(二钱) 炒麦芽(三钱)
清煎三帖。
介按∶寒凝火郁,挟秽浊食滞而阻遏气机,故以芳香逐秽,兼以疏泄清肺为治。
某 便泻已止,脉弦,腹痛肠鸣。姑宜清肝和中。
川楝子(三钱) 新会皮(钱半) 通草(钱半) 生牡蛎(四钱) 茯苓(四钱) 广郁金(三
钱) 炒白芍(钱半) 玫瑰花(五朵) 左金丸(八分) 炒谷芽(四钱) 广木香(七分)
清煎四帖。
介按∶气滞湿阻,六腑不和,以致先泻后痛。但古人以胃为阳土,肝属阴木,治胃必主
泄肝,制其胜也。
安昌陈 腹痛已瘥,脉弦,脘闷气冲,舌微黄,故宜顺气和中。(五月十七日)
乌药(二钱) 川楝子(三钱) 刺蒺藜(三钱) 左金丸(八分) 生牡蛎(钱半) 浓朴(一
钱) 枳壳(钱半) 玫瑰花(五朵) 沉香曲(钱半) 炒青皮(八分) 仙半夏(钱半)
清煎四帖。
介按∶肝热未清,气机阻痹,治以泄肝和胃,方极稳妥。
某 腹痛较瘥,脉沉弦,头晕,仍遵前法加减为妥。(五月十三日)
川楝子(三钱) 刺蒺藜(三钱) 仙半夏(钱半) 沉香曲(钱半) 延胡(二钱) 茯神(四
钱) 新会皮(钱半) 玫瑰花(五朵) 生牡蛎(四钱) 鸡内金(三钱) 左金丸(八分)
清煎二帖。
介按∶肝气稍平,而内风未熄,以致头晕。治以柔肝熄风,兼理气。藉止腹痛而缓晕。
【医案一】
渔庄的沈姓患者。暑热之邪内迫,导致腹部绞痛,大便色赤且排便不畅,脉象弦而濡软,舌质红赤,伴有呕吐恶心,需防止发展为痢疾。(七月二十四日)
藿香(半钱) 红藤(半钱) 炒银花(三钱) 仙半夏(半钱) 左金丸(八分) 广郁金(三钱) 滑石(四钱) 莱菔子(三钱) 省头草(三钱) 川朴(一钱) 枳壳(半钱)
清水煎服两帖。
邵介按:暑热之邪内迫肝经,阻碍气机运行,扰乱肠胃功能,从而导致腹部绞痛。治疗采用平抑肝火、清热、理气止痛的方法,方案非常恰当。
【医案二】
渔庄的沈姓患者。腹痛已经消除,胃气有所恢复,双手脉象皆呈弦象,这是肝气横逆、气机阻滞,阴火不能收敛的表现。暂宜采用养胃泄肝的方法。(八月初三日)
黄草斛(三钱) 左金丸(八分) 焦栀子(三钱) 川楝子(三钱) 生石决明(六钱) 白芍(半钱) 广郁金(三钱) 佛手花(八分) 丹皮(三钱) 枳壳(半钱) 木蝴蝶(四分) (引药)路路通(七枚)
两帖。
邵介按:此症属于腹痛减轻,但肝热未清,胃阴尚未恢复的情况。
【医案三】
安昌的沈姓患者。其女儿腹痛欲呕,寸部脉象弦滑,这是由于寒温失调,夹带食积为患,伴有咳嗽气逆。适宜采用开提肺气、调和脾胃的方法,以防病情变化。(九月二十二日)
桔梗(半钱) 枳壳(半钱) 省头草(三钱) 青木香(七分) 山楂(四钱) 前胡(半钱) 原郁金(三钱) 光杏仁(三钱) 红藤(半钱) 藿香(二钱) 炒麦芽(三钱)
清水煎服三帖。
邵介按:寒凝火郁,夹杂秽浊之气与食滞,阻遏气机,因此采用芳香化浊逐秽,兼以疏泄清肺的治疗方法。
【医案四】
某患者。腹泻已止,脉象弦,出现腹痛肠鸣。暂宜采用清肝和中(调和脾胃)的方法。
川楝子(三钱) 新会皮(半钱) 通草(半钱) 生牡蛎(四钱) 茯苓(四钱) 广郁金(三钱) 炒白芍(半钱) 玫瑰花(五朵) 左金丸(八分) 炒谷芽(四钱) 广木香(七分)
清水煎服四帖。
邵介按:气机阻滞、湿气阻遏,导致六腑功能不和,从而出现先腹泻后腹痛的症状。但古人认为胃属阳土,肝属阴木,治疗胃病必须主泄肝气,以制约肝木对脾土的克制。
【医案五】
安昌的陈姓患者。腹痛已经好转,脉象弦,脘腹闷胀、气机上冲,舌苔微黄,故适宜采用顺气和中(调和脾胃)的方法。(五月十七日)
乌药(二钱) 川楝子(三钱) 刺蒺藜(三钱) 左金丸(八分) 生牡蛎(半钱) 浓朴(一钱) 枳壳(半钱) 玫瑰花(五朵) 沉香曲(半钱) 炒青皮(八分) 仙半夏(半钱)
清水煎服四帖。
邵介按:肝热未清,气机阻痹,治疗采用泄肝和胃的方法,方剂极为稳妥。
【医案六】
某患者。腹痛较前好转,脉象沉弦,伴有头晕,仍遵循前法加减为宜。(五月十三日)
川楝子(三钱) 刺蒺藜(三钱) 仙半夏(半钱) 沉香曲(半钱) 延胡(二钱) 茯神(四钱) 新会皮(半钱) 玫瑰花(五朵) 生牡蛎(四钱) 鸡内金(三钱) 左金丸(八分)
清水煎服两帖。
邵介按:肝气稍得平息,但内风未熄,导致头晕。治疗采用柔肝熄风,兼以理气。借以停止腹痛来缓解头晕。
[Case 1]
Patient Shen from Yuzhuang. Summer-heat pathogen forces inward, causing abdominal pain like wringing, red stool with incomplete defecation, wiry and soggy pulse, red tongue, vomiting and nausea; prevention of dysentery is required. (July 24th)
Huoxiang (0.5 qian) Hongteng (0.5 qian) Chao Yin Hua (3 qian) Xian Banxia (0.5 qian) Zuojin Wan (0.8 fen) Guang Yujin (3 qian) Huashi (4 qian) Laifuzi (3 qian) Shengtoucao (3 qian) Chuanpu (1 qian) Zhike (0.5 qian)
Decocted in clear water, two doses.
Commentary by Shao Jie: Summer-heat pathogen forces into the Liver Meridian, obstructing Qi mechanism and disturbing the intestines and stomach, resulting in colicky abdominal pain. The treatment method of calming the Liver, clearing heat, regulating Qi, and relieving pain is excellent.
[Case 2]
Patient Shen from Yuzhuang. Abdominal pain has been eliminated, Stomach Qi is slightly revitalized, both hands show a wiry pulse. This indicates Liver Qi stagnating horizontally, Qi obstruction, and unconsolidated Yin fire. Temporarily suitable for nourishing the Stomach and draining the Liver. (August 3rd)
Huang Cao Shu (3 qian) Zuojin Wan (0.8 fen) Jiao Zhizi (3 qian) Chuanlianzi (3 qian) Sheng Shijueming (6 qian) Baishao (0.5 qian) Guang Yujin (3 qian) Foshouhua (0.8 fen) Danpi (3 qian) Zhike (0.5 qian) Muhudie (0.4 fen) (Guiding herb) Lulutong (7 pieces)
Two doses.
Commentary by Shao Jie: This case presents with reduced abdominal pain, but Liver heat is not cleared, and Stomach Yin has not recovered.
[Case 3]
Patient Shen from Anchang. His daughter suffers from abdominal pain with urge to vomit, cun position shows wiry and slippery pulse. This is caused by imbalance of cold and warm pathogens, combined with food retention, accompanied by cough and rebellious Qi. Suitable for lifting and harmonizing the Middle Jiao, preventing transformation. (September 22nd)
Jiegeng (0.5 qian) Zhike (0.5 qian) Shengtoucao (3 qian) Qingmuxiang (0.7 fen) Shanzha (4 qian) Qianhu (0.5 qian) Yuan Yujin (3 qian) Guang Xingren (3 qian) Hongteng (0.5 qian) Huoxiang (2 qian) Chao Maiya (3 qian)
Decocted in clear water, three doses.
Commentary by Shao Jie: Cold coagulation and Fire depression, mixed with turbid pathogens and food stasis blocking the Qi mechanism. Therefore, aromatic herbs are used to expel turbidity, combined with dispersing and clearing the Lung.
[Case 4]
Certain patient. Diarrhea has stopped, pulse is wiry, abdominal pain with borborygmus. Temporarily suitable for clearing the Liver and harmonizing the Middle Jiao.
Chuanlianzi (3 qian) Xinhui Pi (0.5 qian) Tongcao (0.5 qian) Sheng Muli (4 qian) Fuling (4 qian) Guang Yujin (3 qian) Chao Baishao (0.5 qian) Meiguihua (5 flowers) Zuojin Wan (0.8 fen) Chao Guya (4 qian) Guang Muxiang (0.7 fen)
Decocted in clear water, four doses.
Commentary by Shao Jie: Qi stagnation and Dampness obstruction lead to disharmony of the Six Fu organs, resulting in diarrhea followed by pain. However, ancients considered the Stomach as Yang Earth and the Liver as Yin Wood. Treating the Stomach must primarily involve draining the Liver to control its excessive restriction.
[Case 5]
Patient Chen from Anchang. Abdominal pain has improved, pulse is wiry, epigastric stuffiness with Qi rushing upward, slight yellow coating on tongue. Thus, suitable for smoothing Qi and harmonizing the Middle Jiao. (May 17th)
Wuyao (2 qian) Chuanlianzi (3 qian) Cijili (3 qian) Zuojin Wan (0.8 fen) Sheng Muli (0.5 qian) Nongpu (1 qian) Zhike (0.5 qian) Meiguihua (5 flowers) Chenxiang Qu (0.5 qian) Chao Qingpi (0.8 fen) Xian Banxia (0.5 qian)
Decocted in clear water, four doses.
Commentary by Shao Jie: Liver heat is not cleared, Qi mechanism is blocked. Treatment involves draining the Liver and harmonizing the Stomach; the prescription is extremely safe and appropriate.
[Case 6]
Certain patient. Abdominal pain has somewhat improved, pulse is deep and wiry, dizziness persists. It is advisable to follow the previous method with modifications. (May 13th)
Chuanlianzi (3 qian) Cijili (3 qian) Xian Banxia (0.5 qian) Chenxiang Qu (0.5 qian) Yanhu (2 qian) Fushen (4 qian) Xinhui Pi (0.5 qian) Meiguihua (5 flowers) Sheng Muli (4 qian) Ji Neijin (3 qian) Zuojin Wan (0.8 fen)
Decocted in clear water, two doses.
Commentary by Shao Jie: Liver Qi has slightly calmed, but internal Wind has not subsided, leading to dizziness. Treatment employs softening the Liver and extinguishing Wind, combined with regulating Qi. This aims to stop abdominal pain thereby alleviating dizziness.