陳(chen)老(lao)諳熟藥(yao)(yao)(yao)性,他認(ren)為:祖國醫(yi)學浩如煙海(hai),各(ge)醫(yi)學流派均有(you)自己的(de)用(yong)(yong)藥(yao)(yao)(yao)特點(dian)及長處。經(jing)方(fang)簡(jian)捷,時方(fang)輕刃(ren),均可借鑒。但要結(jie)(jie)合自己的(de)臨床經(jing)驗(yan)(yan),執其(qi)法(fa)不可拘其(qi)方(fang)泥其(qi)藥(yao)(yao)(yao),人云亦云,要大(da)膽創新。陳(chen)老(lao)頗推徐靈胎(tai)“一(yi)病(bing)必有(you)一(yi)認(ren)方(fang),一(yi)方(fang)必有(you)一(yi)主藥(yao)(yao)(yao)”之說,主張(zhang)精方(fang)簡(jian)藥(yao)(yao)(yao),重(zhong)點(dian)突(tu)出(chu)。嘗謂(wei):“用(yong)(yong)藥(yao)(yao)(yao)如用(yong)(yong)兵(bing),貴乎選帥用(yong)(yong)將不可隨(sui)意(yi)拼湊,以(yi)(yi)圖(tu)面面俱到,如此則互相牽掣(che),藥(yao)(yao)(yao)力難以(yi)(yi)集(ji)中,何以(yi)(yi)愈病(bing)?一(yi)方(fang)之中君藥(yao)(yao)(yao)用(yong)(yong)量(liang)必重(zhong),任(ren)之以(yi)(yi)權,否則即(ji)為無制(zhi)之師,焉能取(qu)勝乎!”寒熱虛實,辨(bian)證已明即(ji)應大(da)膽用(yong)(yong)藥(yao)(yao)(yao)。時感表邪宜輕量(liang)小劑,重(zhong)癥頑(wan)疾亦峻藥(yao)(yao)(yao)攻(gong)堅,滋補藥(yao)(yao)(yao)味(wei)可多(duo),攻(gong)邪藥(yao)(yao)(yao)量(liang)宜重(zhong)。力求精兵(bing)簡(jian)藥(yao)(yao)(yao),彈無虛發,這(zhe)樣既節約藥(yao)(yao)(yao)物(wu),又集(ji)中藥(yao)(yao)(yao)力,且利于觀察療效總(zong)結(jie)(jie)經(jing)驗(yan)(yan)。陳(chen)老(lao)每方(fang)藥(yao)(yao)(yao)物(wu)多(duo)不超過10味(wei),君藥(yao)(yao)(yao)量(liang)重(zhong),多(duo)在30-50g之間,并且注意(yi)效驗(yan)(yan)價廉,很少使(shi)用(yong)(yong)缺藥(yao)(yao)(yao)。
如治療急性黃(huang)疸型肝炎(yan),自擬之茵(yin)陳(chen)(chen)(chen)退(tui)黃(huang)湯(tang):以茵(yin)陳(chen)(chen)(chen)1250g、梔子10g、大黃(huang)10g、膽草15g、紅花(hua)10g、白(bai)茅(mao)根50g、柴胡10g、茯苓30g組成(cheng)。陳(chen)(chen)(chen)老(lao)體(ti)會茵(yin)陳(chen)(chen)(chen)為一年生草本植物,味苦性微寒,陽春三月,百草生發,山野村民常以茵(yin)陳(chen)(chen)(chen)嫩苗煮食代(dai)菜(cai),味美適口,多(duo)食無礙(ai)。該藥療效確切,退(tui)黃(huang)迅速,非大劑(ji)(ji)量不(bu)可,成(cheng)人每劑(ji)(ji)不(bu)少于1000g,兒童不(bu)少于300g。
曾治一李性男患,素(su)體健(jian)康,1周前食欲(yu)減少,惡(e)心(xin)欲(yu)吐,困(kun)倦肢沉,面目色(se)黃(huang)(huang),伴胃脘不適,厭油膩,右(you)(you)脅隱痛(tong),苔黃(huang)(huang)便燥,舌紅苔黃(huang)(huang)而薄,脈弦(xian)數,口腔黏膜黃(huang)(huang)染(ran),鞏膜黃(huang)(huang)染(ran),肝右(you)(you)肋下2cm,質(zhi)軟,觸痛(tong)。肝功化驗(yan):麝濁7u,鋅濁14u,黃(huang)(huang)疸指數25u,轉氨酶425u,碘(dian)反應(ying)(+),診為濕(shi)重(zhong)于熱型黃(huang)(huang)疸,擬清熱利濕(shi)退黃(huang)(huang)法。
處方:茵陳(chen)1250g,梔子15g,黃(huang)柏10g,紅花10g,滑石30g,木通(tong)15g,膽草10g,茅根100g,腹皮(pi)20g。水(shui)煎服。服藥16劑,歷時18天(tian),肝功及黃(huang)疸指(zhi)數均恢復正常,諸癥悉愈出院。
治療(liao)(liao)胃(wei)下(xia)(xia)(xia)垂(chui)、子宮(gong)脫垂(chui)、脫肛等病,常(chang)于補(bu)中益氣(qi)(qi)湯中加入大劑量(liang)(liang)枳(zhi)殼(ke),療(liao)(liao)效滿意。陳老認為臟(zang)器下(xia)(xia)(xia)垂(chui)多中氣(qi)(qi)不足、升提無力(li)所致。中氣(qi)(qi)虛則氣(qi)(qi)機不暢,氣(qi)(qi)滯(zhi)中焦,愈積(ji)愈滯(zhi),升舉愈難,重用(yong)枳(zhi)殼(ke)寬中行(xing)氣(qi)(qi),氣(qi)(qi)行(xing)滿除,中氣(qi)(qi)通暢,下(xia)(xia)(xia)垂(chui)自(zi)可上收:一般用(yong)量(liang)(liang)均在50~100g,無任何不良(liang)反應。
急性腎炎,陳老(lao)常治以越婢加術湯加白(bai)茅(mao)根(gen)、紫(zi)荊皮(pi)等,白(bai)茅(mao)根(gen)用量動輒100-200g。陳老(lao)云:“攻堅之戰,宜重兵速克,以防(fang)疲其師。”茅(mao)根(gen)味甘能(neng)補胃,故(gu)雖寒而不礙胃,清熱(re)涼血通(tong)絡利尿,消腫(zhong)迅速,貴在一(yi)味,常收斬將奪關之效。
用藥(yao)方面(mian),陳老師古(gu)(gu)不泥,嘗謂:“服藥(yao)本為補偏救(jiu)弊,有(you)是(shi)病(bing)則(ze)投是(shi)藥(yao),切(qie)勿為古(gu)(gu)人所(suo)囿。”某(mou)年(nian)隆冬(dong)陳老治(zhi)一(yi)頭(tou)(tou)痛患者(zhe),頭(tou)(tou)痛欲(yu)(yu)裂,呻吟不已,3日(ri)未眠,時(shi)時(shi)以拳(quan)擊(ji)頭(tou)(tou),昏(hun)昏(hun)欲(yu)(yu)仆,舌紅(hong)焦干,六脈洪數,曾服芎(xiong)芷石膏(gao)(gao)湯(tang)數劑不愈。陳老診畢,只將(jiang)方中(zhong)石膏(gao)(gao)改(gai)為150g,服藥(yao)2劑頭(tou)(tou)疼若失(shi)。
陳老云:“冬不(bu)用(yong)石膏(gao),夏(xia)不(bu)用(yong)麻黃(huang),彼言其(qi)常(chang),此治其(qi)變,認(ren)準證即放膽用(yong)藥又何慮(lv)之有?只能考慮(lv)季節因素(su),酌用(yong)量而已(yi),切勿為其(qi)所限。”
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