张隐庵曰。顺治辛卯岁。予年四十有二。八月中生一胃脘痈。在鸠尾斜下右寸许。微肿
不红。按之不痛。隐隐然如一鸡卵在内。姚继元先生视之曰。此胃脘痈也。一名捧心痈。速
宜解散。否则有性命之忧。与一大张膏药。上加末药二三钱。午间烘贴。至暮手足苏软。渐
至身不能转侧。仰卧于书斋。心烦意乱。屏去家人。至初更时。痈上起一毒瓦斯。从左乳下至
肋下胁。入于左肾。入时如烧锥刺入。眼中一阵火光。大如车轮。神气昏晕。痛楚难言。火
光渐摇漾而散。神昏始苏。过半时许。其气复起。其行如旧。痛楚如前。如此者三四次。予
思之。此戊与癸合也。然腑邪入脏。自分必死。妄想此毒瓦斯不从胁下入肾。得从中而入于肠
胃。则生矣。如此静而行之。初次不从。二次即随想而仍从于左乳下入于肠中。腹中大鸣。
无从前之痛楚矣。随起随想。因悟修养之道。气随想而运用者也。(运气法大能起鼓胀之证。
劳怯咳嗽亦妙。)至天明大泄数次。胸膈宽疏。继元先生复视之曰。毒已散解。无妨事矣。
至次年中秋复发。仍用膏药末药。毫无前番之状。而肿亦不消。予因想运气之妙。径行坐卧。
以手按摩
按读此案。知病家不能深信。断断不可勉强相从。且不必言及治当何法。应用何方。恐
后到
张隐庵说:顺治辛卯年,我四十二岁。八月里长了一个胃脘痈(发生在胃脘部位的痈肿),位置在鸠尾穴斜下方右侧约一寸处,微微肿胀但不发红,按压时不痛,隐隐感觉里面像有一个鸡蛋大小的硬块。姚继元先生诊察后说:“这是胃脘痈,又名捧心痈,必须迅速消散解毒,否则会有生命危险。”他给我贴了一张大膏药,上面撒上二三钱末药,中午烘烤后贴上。到了傍晚,手脚变得酥软,逐渐发展到身体无法转动,只能仰卧在书斋中。此时心烦意乱,屏退家人。到初更时分,痈上冒出一股毒气,从左乳下经过肋下胁部,进入左肾。毒气进入时如同烧红的锥子刺入眼中,眼前出现一阵火光,大如车轮,神志昏晕,痛苦难以言表。火光渐渐摇曳消散后,神志才稍微清醒。过了半个多时辰,那股气又起来了,运行路径和之前的疼痛感一样。这种情况反复了三四次。我思考认为,这是因为戊土与癸水相合的缘故。然而腑邪侵入脏,按理必然死亡。我妄想着这股毒气不从胁下进入肾脏,而是从中路进入肠胃,这样或许能活下来。于是静心运用意念引导,第一次没有成功,第二次便随着我的意念,依然从左侧乳下进入肠道中。腹中发出大声鸣响,不再有之前的剧烈疼痛了。每次发作都伴随意念引导,因此领悟到修养的道理:气是随着意念而运行的。(运气法对于治疗鼓胀证非常有效,对劳损虚怯咳嗽也妙用无穷。)直到天亮,我多次腹泻,胸膈感到宽舒通畅。继元先生再次诊察后说:“毒气已经散解,无妨事了。”到了第二年中秋节复发,仍然使用膏药和末药,却完全没有前次的症状,而且肿块也没有消退。我便因想到运气法的奥妙,径直通过坐卧姿势,用手按摩患处。
读这个医案可知,病人不能深信不疑,绝对不能勉强听从医嘱。况且也不必谈论应当采用什么治法、应用什么方剂,恐怕后来的人……
Zhang Yin'an stated: In the Xinmao year of the Shunzhi reign, when I was forty-two years old, in mid-August, I developed a Wei-wan abscess (abscess in the epigastric region). It was located approximately one cun diagonally below and to the right of the Jiwei acupoint. It was slightly swollen but not red, and painless upon palpation. There was a dull sensation as if an egg-sized mass were inside. Mr. Yao Jiyuan examined it and said, "This is a Wei-wan abscess, also known as Pengxin abscess. It must be resolved and dispersed promptly; otherwise, there will be danger to life." He applied a large plaster with two or three qian of powdered medicine on top, warmed it at noon, and then applied it. By evening, my hands and feet became soft and weak, gradually progressing to the point where my body could not turn, forcing me to lie supine in my study. My mind was restless and chaotic, so I dismissed my family members. At the beginning of the first watch (roughly 9-11 PM), a toxic vapor arose from the abscess, traveling from below the left breast through the hypochondrium into the left Kidney. Upon entering, it felt like a burning awl piercing into my eyes, accompanied by a burst of firelight as large as a wheel. My spirit became confused and faint, and the pain was indescribable. As the firelight gradually swayed and dissipated, my consciousness slowly returned. After about half an hour, the Qi rose again, following the same path and causing similar pain. This occurred three or four times. I pondered this and realized it was due to the combination of Wu Earth and Gui Water. Since the pathogenic factor of the Fu organ had entered the Zang organ, death seemed inevitable. I harbored a wish that this toxic vapor would not enter the Kidney via the hypochondrium but would instead enter the intestines and stomach through the middle, which might save my life. Thus, I calmly practiced mental guidance. The first attempt failed, but the second time, following my intention, it still traveled from below the left breast into the intestines. Loud borborygmi occurred in the abdomen, and the previous severe pain ceased. With each recurrence, I guided it with my mind, thereby realizing the principle of self-cultivation: Qi moves according to intention. (The method of directing Qi is highly effective for treating distension syndromes and is also beneficial for consumptive deficiency and cough.) By dawn, I had several episodes of profuse diarrhea, and my chest and diaphragm felt open and relaxed. Mr. Jiyuan re-examined me and said, "The toxicity has been dispersed and resolved; there is no cause for concern." The abscess recurred on the Mid-Autumn Festival of the following year. I used the same plaster and powdered medicine, but without any of the previous symptoms, and the swelling did not subside. I then relied on the subtlety of the Qi-directing method, simply sitting and lying down while massaging the area with my hands.
Reading this case reveals that if the patient lacks firm belief, one must not force compliance. Moreover, it is unnecessary to discuss what treatment method should be employed or which formula should be used, lest later practitioners...