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老朽扎记:《经方实验录》(二十六)
杏林老朽
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Joined: 10 Apr 2008
Posts: 163
Location: 安徽芜湖
杏林老朽Collection
PostPosted: 2008-07-04 16:10:10    Post subject: 老朽扎记:《经方实验录》(二十六) Reply with quote

抵当汤证其一
余尝诊一周姓少女,住小南门,年约十八九,经事三月未行,面色萎黄,少腹微胀,证似干血劳初起。因嘱其吞服大黄蛰虫丸,每服三钱,日三次,尽月可愈。自是之后,遂不复来,意其差矣。越三月,忽一中年妇人扶一女子来请医。顾视此女,面颊以下几瘦不成人,背驼腹胀,两手自按,呻吟不绝。余怪而问之,病已至此,何不早治?妇泣而告曰:此吾女也,三月之前,曾就诊于先生,先生令服丸药,今腹胀加,四肢日削,背骨突出,经仍不行,故再求诊!余闻而骇然,深悔前药之误。然病已奄奄,尤不能不一尽心力。第察其情状,皮骨仅存,少腹胀硬,重按痛益甚。此瘀积内结,不攻其瘀,病焉能除?又虑其元气已伤,恐不胜攻,思先补之。然补能恋邪,尤为不可。于是决以抵当汤予之。
虻虫一钱、水蛭一钱、大黄五钱、桃仁五十粒。
明日母女复偕来,知女下黑瘀甚多,胀减痛平。惟脉虚甚,不宜再下,乃以生地、黄耆、当归、潞党、川芎、白芍、陈皮、茺蔚子活血行气,导其瘀积。一剂之后,遂不复来。后六年,值于途,已生子,年四五岁矣。
【按】丸药之效否,与其原料之是否道地,修合之是否如法,储藏之是否妥善,在在有关,故服大黄蛰虫丸而未效者,不能即谓此丸竟无用也。
注:1. 在在 :处处;到处。

抵当汤证其二
蓄血一证,见于女子者多矣,男子患者甚鲜。某年,余诊一红十字会某姓男子,少腹胀痛,小便清长,且目不识物。论证确为蓄血,而心窃疑之。乃姑投以桃核承气汤,服后片时,即下黑粪,而病证如故。
再投二剂,加重其量,病又依然,心更惊奇。因思此证若非蓄血,服下药三剂,亦宜变成坏病。若果属是证,何以不见少差,此必药轻病重之故也。时门人章次公在侧,曰:与抵当丸何如?余曰:考其证,非轻剂可瘳,乃决以抵当汤下之。服后,黑粪挟宿血齐下。更进一剂,病者即能伏榻静卧,腹胀平,痛亦安。知药已中病,仍以前方减轻其量,计虻虫二钱,水蛭钱半,桃仁五钱,川军五钱。后复减至虻虫、水蛭各四分,桃仁川军各钱半。由章次公调理而愈。后更询诸病者,盖尝因劳力负重,致血凝而结成蓄血证也。

_________________
人之所病,病疾多;而医之所病,病道少。
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