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老朽扎记:《经方实验录》(三十九):历节
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: 2008-10-18 15:10:44    Post subject: 老朽扎记:《经方实验录》(三十九):历节 Reply with quote

耿右,初诊,八月二十七日。一身肢节疼痛,脚痛,足胫冷,日晡所发热,脉沈而滑,此为历节,宜桂枝芍药知母汤。瘰疬,从缓治。
川桂技五钱、赤白芍各三钱、生甘草三钱、生麻黄三钱、熟附块五钱、生白术五钱、肥知母五钱、青防风五钱、生姜一块打。
二诊九月一日服桂枝芍药知母汤,腰痛略减,日晡所热度较低,惟手足痠痛如故,仍宜前法。
川桂技五钱、赤白芍各五钱、生甘草三钱、净麻黄四钱、苍白术各五钱、肥知母五钱、青防风四钱、生姜一块打、咸附子三钱生用勿泡。
【按】吾师又曾治一戴姓妇人妊娠八月,为其夫病求医,抱夫乘车,胎儿竟为夫身压毙,遂作腹痛。一医药而堕之,腐矣,妇本属血虚体质,死胎既下,因贫不能善后,即病历节。手足拘挛,节骱剧痛,旦日较缓。拖延二年,方求师诊。
师用一方,二剂不应。二诊改用某药,汗乃大出。两剂,肢节便可屈伸,足肿亦小,独手发出大泡,有浓有水,将成溃烂。乃采丁甘仁先贤法,用大小蓟各五钱,丹皮一两,地骨皮四钱,清其血热,二剂而痂成,四剂而痂脱。遂与未病时无异。
以为可无恙矣,妇忽阴痒难忍,盖湿毒未尽,而下注也。师因令其用蛇床子煎汤薰洗,良瘥。未几,入市购物,卒然晕倒,诸恙退而血虚之真象见。师乃用大熟地一两,潞党参五钱,川芎、当归各四钱,龙骨、牡蛎各一两,凡二十余剂全愈,后竟抱子云云。
曹颖甫曰:肢节疼痛,病名历节。此证起于风邪外感,汗出不畅,久久湿流关节,脉迟而滑,属寒湿。其微者用桂枝芍药知母汤。其剧者宜乌头扬。尝治一吴姓少病,予用净麻黄三钱,生白芍三钱,生绵耆三钱,炙甘草三钱,乌头二枚切片,用蜜糖一碗另煎,煎至半碗,盖悉本《金匮》法也。
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人之所病,病疾多;而医之所病,病道少。
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