曹女年十七,忽停经九月,人渐瘦,脉沉实,舌白,口渴心烧,中脘痛,少腹左胁下痛而拒按,夜来潮热
盗汗,便结溲少而热,微咳无痰,皮肤枯燥,肌如甲错,无一不是干血痨之症状。但室女停经与妇人稍异,
治法亦各有不同,较之曾经生育之妇人尤为棘手。乃一方用去瘀之法,刺其肝脾各经之穴,其腹痛拒按
之状渐解,一方又以培养新血之法,从期门等穴启其生机,心烧
潮热等症亦退。前后月余,其经复至,诸病霍然。
一日在蒋某家治疾,有附诊者一。三十许之妇人,云日来偶觉胃纳不健,请书一开胃方剂,按其脉大
异之。询其有无他状,云无。余未书方而告其家人曰∶殆矣。其脉二十至必一停,停后不能复还,继而复动,
则与前后不能接续。经云一息不运则生机穷。此在脉法中谓之代脉,虽无大病,必难久存。蒋某以余故神
其说,未之信。十余日后,忽患气塞而没,是乃气脱,非真窒塞也。至此方信余言之不谬。
名画师金健吾,乙丑春病小肠气,左囊肿大,寒热交作,转侧不能者有日矣。余因嗜画,耳其名,由友
人之请托而往诊。乃为针归来、肾俞、气海诸穴,数日即愈,今已十余年而未一发。夫小肠气之病,虽似
有形,而实为气所结,其气一散,其形立消。今之医家,误认为实。在有形之病,可以割而弃之,岂知此
等病朝割去而夕复生,屡生屡割,不死不止。不揣其本而齐其末,即在他事,且犹不可,况病关生死,岂可
草率从动,用剖割草菅人命。因论小肠气,而可悟其他类似之病状治法矣。
曹家女儿十七岁,突然停经九个月,身体逐渐消瘦,脉象沉而有力,舌苔白,口渴且心中烦热,中脘部位疼痛,少腹及左侧胁下疼痛且按压时抗拒,夜间出现潮热和盗汗,大便干结、小便短少且发热,轻微咳嗽无痰,皮肤干枯粗糙,肌肉像鳞片一样交错(肌肤甲错),这些无一不是干血痨的症状。但是,未婚女子停经与已婚妇女略有不同,治疗方法也各有差异,比曾经生育过的妇人更加棘手。于是采用一方用祛除瘀血的方法,针刺肝经和脾经的各穴位,腹痛拒按的症状逐渐缓解;另一方又采用培养新血的方法,从期门等穴位激发生机,心中烦热、潮热等症状也随之消退。前后经过一个多月,月经恢复来潮,各种疾病霍然痊愈。
有一天在蒋某家治病,有一位陪同就诊的人。一位三十岁左右的妇女,说近日偶尔觉得胃口不好,请开一个开胃的方剂,我诊察她的脉象觉得非常异常。询问她是否有其他症状,她说没有。我没有开方,而是告诉她的家人说:恐怕不行了。她的脉搏每跳动二十次必然停顿一次,停顿后不能立即恢复,随后再次跳动,这样就与前后的节律无法接续。医经说“一息不运则生机穷”(呼吸之间气血运行停止,生命机能就穷尽了)。这在脉法中称为代脉,虽然目前没有大病,但必定难以长久存活。蒋某因为我的缘故神化了我的说法,并不相信。十多天后,她突然因气机闭塞而死亡,这实际上是气脱证,并非真正的物理性窒塞。到了这时才相信我的话没有错误。
著名画家金健吾,乙丑年春天患小肠气病,左侧阴囊肿大,寒热交替发作,已经好几天不能翻身侧卧了。我因为喜爱绘画,早就听闻他的名声,经朋友请求前往诊治。我为他针刺归来穴、肾俞穴、气海穴等穴位,几天后就痊愈了,至今十多年没有复发。小肠气这个病,虽然看似有形体表现,但实际上是气机郁结所致,气机一旦疏散,形体立刻消散。现在的医生误认为是实证。对于有形之病,可以手术切除抛弃,哪里知道这种病早晨割除晚上又再生,多次生长多次切割,不死不休。如果不探究根本原因而只处理表面现象,即使在其他事情上尚且不可行,何况关乎生死的大病,怎么能草率地动刀,用剖割手术草菅人命。通过论述小肠气,可以领悟其他类似病症的治疗方法。
Cao's daughter, aged seventeen, suddenly experienced amenorrhea for nine months. Her body gradually emaciated, her pulse was deep and solid (Chen Shi), her tongue coating was white, she felt thirsty with a burning sensation in the heart (Xin Shao), pain in the Zhongwan region (CV12), and pain in the lower abdomen and left hypochondrium that was aggravated by pressure (Ju An). At night, she suffered from tidal fever (Chao Re) and spontaneous sweating during sleep (Dao Han). Her stool was dry, urine was scanty and hot, she had a slight cough without phlegm, her skin was dry and rough, and her muscles resembled scales (Ji Ru Jia Cuo). None of these symptoms were not indicative of Gan Xue Lao (Dry Blood Consumption Disease). However, amenorrhea in an unmarried woman differs slightly from that in a married woman, and the treatment methods also vary; it is particularly tricky compared to women who have given birth. Therefore, one approach used the method of removing blood stasis, needling acupoints on the Liver and Spleen meridians, which gradually alleviated the abdominal pain and tenderness. Another approach used the method of nourishing new blood, stimulating vitality from acupoints such as Qimen (LR14), which also subsided the symptoms of burning sensation in the heart and tidal fever. After more than a month, menstruation resumed, and all illnesses vanished instantly.
One day, while treating a patient at Mr. Jiang's residence, there was an accompanying visitor. A woman in her thirties claimed that recently she occasionally felt poor appetite and requested a prescription to open the stomach. Upon palpating her pulse, I found it extremely abnormal. I asked if she had any other symptoms, and she said no. I did not prescribe a formula but told her family, "It seems dire." Her pulse beat twenty times before pausing once; after the pause, it could not immediately resume, and subsequent beats failed to connect with the previous rhythm. The Classics state: "If breath does not move for one respiration, the source of life is exhausted." In pulse diagnosis, this is called Dai Mai (Intermittent Pulse). Although there was no major illness currently, she would certainly not survive long. Mr. Jiang, due to my reputation, mystified my statement and did not believe it. More than ten days later, she suddenly died from Qi obstruction, which was actually Qi Collapse (Qi Tuo) rather than true physical blockage. Only then did they believe my words were correct.
The famous painter Jin Jianwu suffered from Xiao Chang Qi (Small Intestine Qi Disorder) in the spring of the Yichou year. His left scrotum was swollen and large, alternating chills and fever occurred, and he had been unable to turn over or change position for several days. Because I admired painting and knew his name, I went to diagnose him at the request of a friend. I needled the acupoints Guilai (ST29), Shenshu (BL23), and Qihai (CV6). He recovered in a few days and has not relapsed for over ten years. The disease of Xiao Chang Qi, although appearing to have a physical form, is actually caused by Qi knotting. Once the Qi disperses, the form disappears immediately. Current physicians mistakenly consider it an Excess syndrome. For diseases with physical forms, surgical excision might be considered, but how can one know that such diseases regenerate overnight after removal? Repeated growth and cutting will not cease until death. If one does not examine the root cause but only addresses the branch manifestations, it is inadvisable even in trivial matters, let alone in life-and-death diseases. How can one rashly resort to surgery, treating human lives as worthless weeds? By discussing Xiao Chang Qi, one can comprehend the treatment methods for other similar conditions.