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清代名醫王旭高的培土泄木法擅治一餓就難受,吃一點就飽

夏枯草 2023-07-24 12:18:52

清代名(ming)醫(yi)(yi)王(wang)(wang)旭高(gao),醫(yi)(yi)術精深(shen),醫(yi)(yi)德高(gao)尚。起(qi)初從事(shi)外(wai)科,后(hou)(hou)(hou)(hou)來(lai)(lai)專力(li)于(yu)內科雜病(bing)(bing)(bing),且(qie)對溫病(bing)(bing)(bing)尤(you)(you)多(duo)關(guan)注,臨(lin)證(zheng)(zheng)審征用(yong)(yong)(yong)藥甚為(wei)(wei)精當(dang)。他的《西溪書屋夜話錄》作(zuo)為(wei)(wei)肝(gan)(gan)病(bing)(bing)(bing)證(zheng)(zheng)治的專篇(pian),對后(hou)(hou)(hou)(hou)世(shi)產生(sheng)了(le)深(shen)遠影響。其(qi)(qi)法(fa)(fa)(fa)曰:培(pei)(pei)(pei)(pei)土(tu)(tu)(tu)泄(xie)(xie)木(mu)(mu)(mu)(mu)。肝(gan)(gan)氣(qi)(qi)乘脾(pi)(pi),脘(wan)(wan)(wan)(wan)腹(fu)脹(zhang)(zhang)(zhang)痛(tong)(tong)(tong),六君子湯加(jia)(jia)吳茱萸、白(bai)芍藥、木(mu)(mu)(mu)(mu)香(xiang)(xiang),即(ji)培(pei)(pei)(pei)(pei)土(tu)(tu)(tu)泄(xie)(xie)木(mu)(mu)(mu)(mu)之(zhi)(zhi)(zhi)(zhi)(zhi)法(fa)(fa)(fa)也(ye),溫中(zhong)(zhong)(zhong)(zhong)(zhong)疏木(mu)(mu)(mu)(mu)也(ye)。黃(huang)玉楸(qiu)慣用(yong)(yong)(yong)此(ci)法(fa)(fa)(fa)。病(bing)(bing)(bing)例(li)張某(mou)(mou),女,17歲。石家莊市(shi)一(yi)中(zhong)(zhong)(zhong)(zhong)(zhong)學生(sheng)。2008年(nian)7月(yue)(yue)(yue)(yue)(yue)13日(ri)(ri)(ri)(ri)(ri)(ri)初診(zhen)(zhen)(zhen)(zhen)。患者(zhe)(zhe)為(wei)(wei)高(gao)中(zhong)(zhong)(zhong)(zhong)(zhong)一(yi)年(nian)級學生(sheng)。訴(su)13歲月(yue)(yue)(yue)(yue)(yue)經(jing)來(lai)(lai)潮(chao),經(jing)期尚準(zhun),但(dan)經(jing)行(xing)(xing)第1天必腹(fu)痛(tong)(tong)(tong)且(qie)脹(zhang)(zhang)(zhang),痛(tong)(tong)(tong)甚于(yu)脹(zhang)(zhang)(zhang)。經(jing)期腰酸,并且(qie)大腿根(gen)痛(tong)(tong)(tong)。經(jing)行(xing)(xing)大便(bian)(bian)(bian)不(bu)(bu)(bu)(bu)(bu)暢(chang),矢(shi)氣(qi)(qi)亦(yi)不(bu)(bu)(bu)(bu)(bu)暢(chang)。從上初中(zhong)(zhong)(zhong)(zhong)(zhong)始,平(ping)(ping)時(shi)即(ji)怕(pa)冷(leng)(leng)(leng),不(bu)(bu)(bu)(bu)(bu)能(neng)(neng)吃涼東(dong)西,經(jing)期小(xiao)腹(fu)尤(you)(you)喜(xi)暖怕(pa)冷(leng)(leng)(leng)。餓(e)時(shi)心(xin)(xin)中(zhong)(zhong)(zhong)(zhong)(zhong)難受(shou),要(yao)趕緊吃,而(er)(er)(er)(er)且(qie)特別容易(yi)餓(e),但(dan)吃一(yi)點(dian)(dian)(dian)(dian)就飽,飯量很小(xiao)。全(quan)(quan)身(shen)乏力(li),上4樓(lou)即(ji)覺(jue)氣(qi)(qi)短而(er)(er)(er)(er)似(si)喘。夜夢(meng)多(duo)。末次(ci)(ci)(ci)月(yue)(yue)(yue)(yue)(yue)經(jing)6月(yue)(yue)(yue)(yue)(yue)23日(ri)(ri)(ri)(ri)(ri)(ri),共經(jing)行(xing)(xing)6天。脈虛(xu)軟(ruan)(ruan)(ruan),沉(chen)取(qu)(qu)有(you)(you)(you)弦意。舌(she)(she)淡紅,苔薄(bo)白(bai)膩。予王(wang)(wang)旭高(gao)培(pei)(pei)(pei)(pei)土(tu)(tu)(tu)泄(xie)(xie)木(mu)(mu)(mu)(mu)方(fang)(fang)(fang)(fang)(fang)(黨參(can)、白(bai)術、茯苓、陳皮、半(ban)(ban)夏(xia)、木(mu)(mu)(mu)(mu)香(xiang)(xiang)、白(bai)芍各10克(ke)(ke)(ke)(ke),吳茱萸、炙甘(gan)(gan)草各6克(ke)(ke)(ke)(ke)。下(xia)(xia)同)加(jia)(jia)當(dang)歸、川芎、焦三仙各10克(ke)(ke)(ke)(ke)。7劑(ji)(ji),每(mei)(mei)日(ri)(ri)(ri)(ri)(ri)(ri)1劑(ji)(ji),水煎服(fu)(fu)。二(er)診(zhen)(zhen)(zhen)(zhen):7月(yue)(yue)(yue)(yue)(yue)20日(ri)(ri)(ri)(ri)(ri)(ri)。餓(e)時(shi)難受(shou)感(gan)減輕了(le),能(neng)(neng)多(duo)吃些(xie)飯了(le)。夜夢(meng)亦(yi)少,全(quan)(quan)身(shen)怕(pa)冷(leng)(leng)(leng)及(ji)(ji)上樓(lou)氣(qi)(qi)短之(zhi)(zhi)(zhi)(zhi)(zhi)感(gan)均(jun)(jun)減。近日(ri)(ri)(ri)(ri)(ri)(ri)大便(bian)(bian)(bian)1~2天1次(ci)(ci)(ci),仍(reng)不(bu)(bu)(bu)(bu)(bu)暢(chang)快。上方(fang)(fang)(fang)(fang)(fang)加(jia)(jia)香(xiang)(xiang)附、薤白(bai)各10克(ke)(ke)(ke)(ke)。7劑(ji)(ji)。三診(zhen)(zhen)(zhen)(zhen):7月(yue)(yue)(yue)(yue)(yue)27日(ri)(ri)(ri)(ri)(ri)(ri)。7月(yue)(yue)(yue)(yue)(yue)23日(ri)(ri)(ri)(ri)(ri)(ri)經(jing)至,今(jin)已(yi)(yi)凈(jing),疼(teng)痛(tong)(tong)(tong)已(yi)(yi)大減。以前經(jing)行(xing)(xing)小(xiao)腹(fu)發(fa)(fa)憋脹(zhang)(zhang)(zhang),矢(shi)氣(qi)(qi)不(bu)(bu)(bu)(bu)(bu)暢(chang),現(xian)均(jun)(jun)消失。餓(e)時(shi)難受(shou)之(zhi)(zhi)(zhi)(zhi)(zhi)感(gan)基本(ben)消失,飲食(shi)(shi)(shi)(shi)(shi)已(yi)(yi)正(zheng)常。但(dan)活動(dong)久仍(reng)覺(jue)疲累,不(bu)(bu)(bu)(bu)(bu)愿活動(dong)。上方(fang)(fang)(fang)(fang)(fang)再加(jia)(jia)黨參(can)、白(bai)芍各6克(ke)(ke)(ke)(ke)。7劑(ji)(ji)。四診(zhen)(zhen)(zhen)(zhen):8月(yue)(yue)(yue)(yue)(yue)3日(ri)(ri)(ri)(ri)(ri)(ri)。動(dong)后(hou)(hou)(hou)(hou)疲累感(gan)明顯減輕,已(yi)(yi)無明顯不(bu)(bu)(bu)(bu)(bu)適。原(yuan)方(fang)(fang)(fang)(fang)(fang)再服(fu)(fu)14劑(ji)(ji),下(xia)(xia)次(ci)(ci)(ci)來(lai)(lai)月(yue)(yue)(yue)(yue)(yue)經(jing)后(hou)(hou)(hou)(hou)再診(zhen)(zhen)(zhen)(zhen)。五診(zhen)(zhen)(zhen)(zhen):8月(yue)(yue)(yue)(yue)(yue)23日(ri)(ri)(ri)(ri)(ri)(ri)。訴(su)昨天已(yi)(yi)來(lai)(lai)月(yue)(yue)(yue)(yue)(yue)經(jing),腹(fu)痛(tong)(tong)(tong)及(ji)(ji)脹(zhang)(zhang)(zhang)未(wei)(wei)(wei)發(fa)(fa),飲食(shi)(shi)(shi)(shi)(shi)、二(er)便(bian)(bian)(bian)、體力(li)均(jun)(jun)已(yi)(yi)恢復正(zheng)常。后(hou)(hou)(hou)(hou)隨防,知(zhi)病(bing)(bing)(bing)未(wei)(wei)(wei)再發(fa)(fa)。按(an):筆(bi)者(zhe)(zhe)長期思(si)考并尋找王(wang)(wang)氏培(pei)(pei)(pei)(pei)土(tu)(tu)(tu)泄(xie)(xie)木(mu)(mu)(mu)(mu)方(fang)(fang)(fang)(fang)(fang)主(zhu)(zhu)(zhu)癥(zheng)(zheng)(zheng),通過(guo)(guo)大量臨(lin)床病(bing)(bing)(bing)例(li),終于(yu)發(fa)(fa)現(xian)其(qi)(qi)主(zhu)(zhu)(zhu)癥(zheng)(zheng)(zheng)是:餓(e)時(shi)心(xin)(xin)中(zhong)(zhong)(zhong)(zhong)(zhong)(即(ji)胃(wei)(wei))空(kong)虛(xu)難受(shou),欲(yu)速食(shi)(shi)(shi)(shi)(shi),但(dan)又(you)不(bu)(bu)(bu)(bu)(bu)能(neng)(neng)多(duo)食(shi)(shi)(shi)(shi)(shi),少食(shi)(shi)(shi)(shi)(shi)即(ji)飽,過(guo)(guo)一(yi)會兒又(you)覺(jue)餓(e),飯量很小(xiao),飲食(shi)(shi)(shi)(shi)(shi)喜(xi)熱惡涼。見此(ci)主(zhu)(zhu)(zhu)癥(zheng)(zheng)(zheng),不(bu)(bu)(bu)(bu)(bu)論任(ren)何(he)疾病(bing)(bing)(bing),均(jun)(jun)可予此(ci)方(fang)(fang)(fang)(fang)(fang)治療。本(ben)例(li)乃(nai)(nai)痛(tong)(tong)(tong)經(jing)病(bing)(bing)(bing),亦(yi)依此(ci)而(er)(er)(er)(er)治愈,再一(yi)次(ci)(ci)(ci)證(zheng)(zheng)明抓主(zhu)(zhu)(zhu)癥(zheng)(zheng)(zheng)的重(zhong)(zhong)要(yao)性(xing)。中(zhong)(zhong)(zhong)(zhong)(zhong)醫(yi)(yi)療效之(zhi)(zhi)(zhi)(zhi)(zhi)可以重(zhong)(zhong)復者(zhe)(zhe),全(quan)(quan)在(zai)于(yu)此(ci)。蓋(gai)本(ben)證(zheng)(zheng)脾(pi)(pi)胃(wei)(wei)虛(xu)弱為(wei)(wei)本(ben),故饑則(ze)必欲(yu)速食(shi)(shi)(shi)(shi)(shi),但(dan)木(mu)(mu)(mu)(mu)橫克(ke)(ke)(ke)(ke)土(tu)(tu)(tu),脾(pi)(pi)胃(wei)(wei)之(zhi)(zhi)(zhi)(zhi)(zhi)氣(qi)(qi)升降(jiang)受(shou)阻,則(ze)受(shou)納無力(li),運化(hua)遲鈍,又(you)不(bu)(bu)(bu)(bu)(bu)能(neng)(neng)飽食(shi)(shi)(shi)(shi)(shi)。正(zheng)因(yin)(yin)如此(ci)食(shi)(shi)(shi)(shi)(shi)少,營養(yang)化(hua)源不(bu)(bu)(bu)(bu)(bu)足(zu),故稍后(hou)(hou)(hou)(hou)又(you)覺(jue)餓(e)而(er)(er)(er)(er)難忍。其(qi)(qi)飲食(shi)(shi)(shi)(shi)(shi)喜(xi)暖而(er)(er)(er)(er)惡冷(leng)(leng)(leng),以其(qi)(qi)中(zhong)(zhong)(zhong)(zhong)(zhong)虛(xu)且(qie)寒(han)也(ye)。脾(pi)(pi)胃(wei)(wei)虛(xu)寒(han)并兼(jian)肝(gan)(gan)木(mu)(mu)(mu)(mu)克(ke)(ke)(ke)(ke)土(tu)(tu)(tu)而(er)(er)(er)(er)氣(qi)(qi)血運行(xing)(xing)不(bu)(bu)(bu)(bu)(bu)暢(chang),則(ze)痛(tong)(tong)(tong)經(jing)發(fa)(fa)矣(yi)。其(qi)(qi)經(jing)行(xing)(xing)腰酸則(ze)多(duo)在(zai)腰陽(yang)關(guan)處,與大腿根(gen)痛(tong)(tong)(tong)均(jun)(jun)屬肝(gan)(gan)經(jing)氣(qi)(qi)血運行(xing)(xing)不(bu)(bu)(bu)(bu)(bu)暢(chang)之(zhi)(zhi)(zhi)(zhi)(zhi)象,故并現(xian)大便(bian)(bian)(bian)與矢(shi)氣(qi)(qi)不(bu)(bu)(bu)(bu)(bu)暢(chang)。中(zhong)(zhong)(zhong)(zhong)(zhong)氣(qi)(qi)不(bu)(bu)(bu)(bu)(bu)足(zu)故體力(li)衰弱而(er)(er)(er)(er)上樓(lou)用(yong)(yong)(yong)力(li)則(ze)氣(qi)(qi)短。脈虛(xu)軟(ruan)(ruan)(ruan),乃(nai)(nai)脾(pi)(pi)胃(wei)(wei)氣(qi)(qi)虛(xu),沉(chen)取(qu)(qu)有(you)(you)(you)弦意則(ze)屬肝(gan)(gan)氣(qi)(qi)疏泄(xie)(xie)失常之(zhi)(zhi)(zhi)(zhi)(zhi)象。且(qie)肝(gan)(gan)為(wei)(wei)女子之(zhi)(zhi)(zhi)(zhi)(zhi)先天,脾(pi)(pi)胃(wei)(wei)又(you)為(wei)(wei)經(jing)血生(sheng)化(hua)之(zhi)(zhi)(zhi)(zhi)(zhi)來(lai)(lai)源,因(yin)(yin)此(ci)調經(jing)尤(you)(you)應重(zhong)(zhong)視調理木(mu)(mu)(mu)(mu)土(tu)(tu)(tu)關(guan)系,使之(zhi)(zhi)(zhi)(zhi)(zhi)恢復相輔相成之(zhi)(zhi)(zhi)(zhi)(zhi)正(zheng)常狀(zhuang)態。王(wang)(wang)氏此(ci)方(fang)(fang)(fang)(fang)(fang)恰具此(ci)功,故用(yong)(yong)(yong)后(hou)(hou)(hou)(hou)即(ji)效。病(bing)(bing)(bing)例(li)一(yi)王(wang)(wang)某(mou)(mou),女,42歲。住(zhu)石家莊市(shi)東(dong)五里村。1993年(nian)9月(yue)(yue)(yue)(yue)(yue)13日(ri)(ri)(ri)(ri)(ri)(ri)初診(zhen)(zhen)(zhen)(zhen)。患者(zhe)(zhe)由去(qu)年(nian)秋季即(ji)常發(fa)(fa)上腹(fu)部(bu)(bu)發(fa)(fa)脹(zhang)(zhang)(zhang)。訴(su)胃(wei)(wei)脘(wan)(wan)(wan)(wan)部(bu)(bu)位饑餓(e)時(shi)疼(teng)痛(tong)(tong)(tong),但(dan)食(shi)(shi)(shi)(shi)(shi)后(hou)(hou)(hou)(hou)卻覺(jue)脹(zhang)(zhang)(zhang)滿(man)不(bu)(bu)(bu)(bu)(bu)舒,故不(bu)(bu)(bu)(bu)(bu)敢(gan)吃飽。特別怕(pa)食(shi)(shi)(shi)(shi)(shi)冷(leng)(leng)(leng)物。拍擊其(qi)(qi)胃(wei)(wei)脘(wan)(wan)(wan)(wan)部(bu)(bu)有(you)(you)(you)水聲,此(ci)處有(you)(you)(you)時(shi)并覺(jue)悸動(dong)不(bu)(bu)(bu)(bu)(bu)安。脈細軟(ruan)(ruan)(ruan)偏數,沉(chen)取(qu)(qu)有(you)(you)(you)弦意,舌(she)(she)尖右(you)側有(you)(you)(you)紫點(dian)(dian)(dian)(dian),苔薄(bo)白(bai)滑膩。予王(wang)(wang)旭高(gao)培(pei)(pei)(pei)(pei)土(tu)(tu)(tu)泄(xie)(xie)木(mu)(mu)(mu)(mu)方(fang)(fang)(fang)(fang)(fang)原(yuan)方(fang)(fang)(fang)(fang)(fang)加(jia)(jia)當(dang)歸、桂(gui)枝、神曲(qu)、麥芽各10克(ke)(ke)(ke)(ke)。3劑(ji)(ji),每(mei)(mei)日(ri)(ri)(ri)(ri)(ri)(ri)1劑(ji)(ji),水煎服(fu)(fu)。二(er)診(zhen)(zhen)(zhen)(zhen):9月(yue)(yue)(yue)(yue)(yue)16日(ri)(ri)(ri)(ri)(ri)(ri)。脘(wan)(wan)(wan)(wan)脹(zhang)(zhang)(zhang)已(yi)(yi)大減,但(dan)訴(su)飯后(hou)(hou)(hou)(hou)半(ban)(ban)小(xiao)時(shi)仍(reng)有(you)(you)(you)脹(zhang)(zhang)(zhang)感(gan),上午(wu)10點(dian)(dian)(dian)(dian)即(ji)有(you)(you)(you)餓(e)感(gan)且(qie)胃(wei)(wei)痛(tong)(tong)(tong),下(xia)(xia)午(wu)4~5點(dian)(dian)(dian)(dian)又(you)略有(you)(you)(you)疼(teng)痛(tong)(tong)(tong)。重(zhong)(zhong)按(an)其(qi)(qi)中(zhong)(zhong)(zhong)(zhong)(zhong)脘(wan)(wan)(wan)(wan)部(bu)(bu)及(ji)(ji)臍上有(you)(you)(you)疼(teng)痛(tong)(tong)(tong)。上方(fang)(fang)(fang)(fang)(fang)加(jia)(jia)川芎10克(ke)(ke)(ke)(ke)。7劑(ji)(ji)。三診(zhen)(zhen)(zhen)(zhen):9月(yue)(yue)(yue)(yue)(yue)23日(ri)(ri)(ri)(ri)(ri)(ri)。脘(wan)(wan)(wan)(wan)脹(zhang)(zhang)(zhang)、胃(wei)(wei)痛(tong)(tong)(tong)諸癥(zheng)(zheng)(zheng)均(jun)(jun)除。已(yi)(yi)能(neng)(neng)食(shi)(shi)(shi)(shi)(shi)飽,胃(wei)(wei)脘(wan)(wan)(wan)(wan)部(bu)(bu)振水音及(ji)(ji)悸動(dong)感(gan)消失。原(yuan)方(fang)(fang)(fang)(fang)(fang)繼(ji)服(fu)(fu)10劑(ji)(ji)。后(hou)(hou)(hou)(hou)來(lai)(lai)訴(su),諸癥(zheng)(zheng)(zheng)均(jun)(jun)未(wei)(wei)(wei)復發(fa)(fa)。按(an):此(ci)例(li)亦(yi)具王(wang)(wang)氏培(pei)(pei)(pei)(pei)土(tu)(tu)(tu)泄(xie)(xie)木(mu)(mu)(mu)(mu)方(fang)(fang)(fang)(fang)(fang)主(zhu)(zhu)(zhu)癥(zheng)(zheng)(zheng),但(dan)因(yin)(yin)食(shi)(shi)(shi)(shi)(shi)后(hou)(hou)(hou)(hou)脹(zhang)(zhang)(zhang)滿(man)明顯,并胃(wei)(wei)脘(wan)(wan)(wan)(wan)部(bu)(bu)有(you)(you)(you)振水音及(ji)(ji)心(xin)(xin)下(xia)(xia)悸,故首(shou)診(zhen)(zhen)(zhen)(zhen)合苓桂(gui)術甘(gan)(gan)湯法(fa)(fa)(fa),二(er)診(zhen)(zhen)(zhen)(zhen)重(zhong)(zhong)按(an)其(qi)(qi)中(zhong)(zhong)(zhong)(zhong)(zhong)脘(wan)(wan)(wan)(wan)及(ji)(ji)臍上有(you)(you)(you)疼(teng)痛(tong)(tong)(tong),故加(jia)(jia)川芎,合上方(fang)(fang)(fang)(fang)(fang)當(dang)歸以活血化(hua)瘀。可見,本(ben)證(zheng)(zheng)較王(wang)(wang)氏培(pei)(pei)(pei)(pei)土(tu)(tu)(tu)泄(xie)(xie)木(mu)(mu)(mu)(mu)方(fang)(fang)(fang)(fang)(fang)證(zheng)(zheng)又(you)增水飲及(ji)(ji)瘀血,故加(jia)(jia)味治之(zhi)(zhi)(zhi)(zhi)(zhi)。病(bing)(bing)(bing)例(li)二(er)肖(xiao)某(mou)(mou),男,54歲。黑龍江省伊(yi)春市(shi)人。1991年(nian)12月(yue)(yue)(yue)(yue)(yue)19日(ri)(ri)(ri)(ri)(ri)(ri)初診(zhen)(zhen)(zhen)(zhen)。去(qu)年(nian)5月(yue)(yue)(yue)(yue)(yue)31日(ri)(ri)(ri)(ri)(ri)(ri)因(yin)(yin)壞死(si)性(xing)膽囊炎(yan)在(zai)當(dang)地醫(yi)(yi)院手(shou)(shou)術切除膽囊。手(shou)(shou)術前即(ji)每(mei)(mei)夜間(jian)2~3點(dian)(dian)(dian)(dian)必大便(bian)(bian)(bian)溏(tang)(tang)(tang)瀉1~2次(ci)(ci)(ci),至今(jin)已(yi)(yi)3~4年(nian)不(bu)(bu)(bu)(bu)(bu)愈,便(bian)(bian)(bian)前腹(fu)痛(tong)(tong)(tong),便(bian)(bian)(bian)后(hou)(hou)(hou)(hou)稍減。白(bai)天則(ze)大便(bian)(bian)(bian)溏(tang)(tang)(tang)瀉3~4次(ci)(ci)(ci),便(bian)(bian)(bian)前微痛(tong)(tong)(tong),便(bian)(bian)(bian)后(hou)(hou)(hou)(hou)痛(tong)(tong)(tong)可止。此(ci)癥(zheng)(zheng)(zheng)手(shou)(shou)術后(hou)(hou)(hou)(hou)依然(ran)不(bu)(bu)(bu)(bu)(bu)減。常伴吐(tu)酸燒心(xin)(xin),夜睡多(duo)夢(meng)。平(ping)(ping)時(shi)常發(fa)(fa)偏左頭(tou)痛(tong)(tong)(tong)。脈左沉(chen)弦,右(you)虛(xu)緩,舌(she)(she)暗(an)紅,苔薄(bo)白(bai)膩。予王(wang)(wang)旭高(gao)培(pei)(pei)(pei)(pei)土(tu)(tu)(tu)泄(xie)(xie)木(mu)(mu)(mu)(mu)方(fang)(fang)(fang)(fang)(fang)原(yuan)方(fang)(fang)(fang)(fang)(fang)加(jia)(jia)黃(huang)連3克(ke)(ke)(ke)(ke),烏賊(zei)骨(gu)30克(ke)(ke)(ke)(ke),砂仁6克(ke)(ke)(ke)(ke)。7劑(ji)(ji),每(mei)(mei)日(ri)(ri)(ri)(ri)(ri)(ri)1劑(ji)(ji),水煎服(fu)(fu)。二(er)診(zhen)(zhen)(zhen)(zhen):12月(yue)(yue)(yue)(yue)(yue)26日(ri)(ri)(ri)(ri)(ri)(ri)。患者(zhe)(zhe)夜間(jian)已(yi)(yi)不(bu)(bu)(bu)(bu)(bu)大便(bian)(bian)(bian),只是早飯前后(hou)(hou)(hou)(hou)各大便(bian)(bian)(bian)1次(ci)(ci)(ci),偏軟(ruan)(ruan)(ruan),不(bu)(bu)(bu)(bu)(bu)溏(tang)(tang)(tang)、不(bu)(bu)(bu)(bu)(bu)散(san)。腹(fu)痛(tong)(tong)(tong)未(wei)(wei)(wei)發(fa)(fa)。已(yi)(yi)不(bu)(bu)(bu)(bu)(bu)燒心(xin)(xin)吐(tu)酸。未(wei)(wei)(wei)發(fa)(fa)頭(tou)痛(tong)(tong)(tong)。上方(fang)(fang)(fang)(fang)(fang)加(jia)(jia)炮(pao)姜10克(ke)(ke)(ke)(ke)。7劑(ji)(ji)。三診(zhen)(zhen)(zhen)(zhen):1月(yue)(yue)(yue)(yue)(yue)2日(ri)(ri)(ri)(ri)(ri)(ri)。大便(bian)(bian)(bian)已(yi)(yi)完全(quan)(quan)正(zheng)常,成形,日(ri)(ri)(ri)(ri)(ri)(ri)便(bian)(bian)(bian)1次(ci)(ci)(ci)。囑(zhu)其(qi)(qi)原(yuan)方(fang)(fang)(fang)(fang)(fang)繼(ji)服(fu)(fu)15劑(ji)(ji)。后(hou)(hou)(hou)(hou)詢之(zhi)(zhi)(zhi)(zhi)(zhi),知(zhi)病(bing)(bing)(bing)未(wei)(wei)(wei)復發(fa)(fa)。按(an):本(ben)例(li)患者(zhe)(zhe)夜間(jian)2~3點(dian)(dian)(dian)(dian)必發(fa)(fa)腹(fu)痛(tong)(tong)(tong)而(er)(er)(er)(er)便(bian)(bian)(bian)溏(tang)(tang)(tang),且(qie)平(ping)(ping)時(shi)即(ji)有(you)(you)(you)燒心(xin)(xin)、吐(tu)酸,均(jun)(jun)屬肝(gan)(gan)木(mu)(mu)(mu)(mu)乘虛(xu)克(ke)(ke)(ke)(ke)制(zhi)脾(pi)(pi)土(tu)(tu)(tu)之(zhi)(zhi)(zhi)(zhi)(zhi)象,以凌(ling)晨乃(nai)(nai)肝(gan)(gan)木(mu)(mu)(mu)(mu)升發(fa)(fa)之(zhi)(zhi)(zhi)(zhi)(zhi)時(shi)也(ye)。此(ci)類疾病(bing)(bing)(bing)切不(bu)(bu)(bu)(bu)(bu)可誤(wu)認為(wei)(wei)腎陽(yang)虛(xu)而(er)(er)(er)(er)用(yong)(yong)(yong)四神丸。予王(wang)(wang)氏培(pei)(pei)(pei)(pei)土(tu)(tu)(tu)泄(xie)(xie)木(mu)(mu)(mu)(mu)方(fang)(fang)(fang)(fang)(fang)加(jia)(jia)黃(huang)連,成戊己(ji)丸法(fa)(fa)(fa),符合苦、辛、酸泄(xie)(xie)肝(gan)(gan)治則(ze),更加(jia)(jia)烏賊(zei)骨(gu)制(zhi)酸、砂仁溫中(zhong)(zhong)(zhong)(zhong)(zhong)散(san)寒(han)(后(hou)(hou)(hou)(hou)又(you)加(jia)(jia)炮(pao)姜亦(yi)屬此(ci)功能(neng)(neng)),則(ze)諸癥(zheng)(zheng)(zheng)均(jun)(jun)愈。

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