少阴寒化 四逆汤证案

患者,男,六十岁。伤寒误汗后,但欲寐,恶寒蜷卧,四肢厥冷至肘膝,下利清谷,小便清长,冷汗自出,不渴或渴喜热饮。舌淡胖苔白滑,脉沉微欲绝。

A sixty-year-old male. After mistaken induction of sweat in a cold-damage illness, he was only drowsy, curled up with aversion to cold, his limbs icy cold up to elbow and knee, passing clear undigested stool and copious clear urine, with cold spontaneous sweat, no thirst or thirst desiring warm drink. Tongue pale and swollen with white slippery coat; pulse deep, faint, on the verge of expiring.

少阴寒化,阳气衰微,阴寒内盛,真阳欲脱。

Shaoyin cold-transformation: yang qi is declining, yin-cold rages within, and the true yang is on the point of collapse.

急煎四逆汤一剂,令频频温服。服后四肢渐温,冷汗止,下利减。继进二剂,脉渐有力,神清能食。后以附子理中丸调养半月,精神复常。

Si Ni Tang was urgently decocted and given in frequent warm sips. After dosing the limbs gradually warmed, the cold sweat stopped, and diarrhea lessened. Two further doses restored pulse strength, clear spirit, and appetite. Fu Zi Li Zhong Wan was then used for half a month, and normal vigour returned.