治腹满发热,以阳并阴,则阳实而阴虚,阳盛生外热,阴虚生内热,脉必
浮数,浮则为虚,数则为热,阴虚不能宣导,饮食如故,致胀满者,为热胀。
浓朴(姜制炒,一两) 甘草(炙) 大黄(蒸,各三钱三字) 枳实(麸炒去瓤,半两) 桂心(一分)
上为锉散。每服四大钱,水盏半,姜七片,枣三个,煎七分,去滓,食前服。呕者,加
半夏一分;利者,去大黄;寒多,加生姜十片煎。
治腹虚胀满,朝缓暮急,服诸药不瘥,恶风,不能宣泄,彭彭鼓胀。
寒蚕绵(烧灰,半两) 麝香(半钱,别研)
上研细令匀。每服一大钱匕,浓煎薄荷汤调下;酒服尤佳,不以时。一法有干漆炒大烟
出,量虚实用之,虚则不可用。
治虚人老人饮啖生冷,多致腹胀,心下痞满,有妨饮食,或刺痛泄利,气痞滞闷。
浓朴(去皮,细锉) 甘草(锉细) 生姜(洗切) 青州枣(切,各等分)
上二件,捣令得所,方入生姜,又杵令匀,取出,同枣焙,令 微燥,却入
锅内,慢火炒至紫色,又焙干为细末。每服一大钱,擦生姜少许,沸汤点,空腹服,以知为
度。气味殊美,兼能愈疾,又易修合。
上件诸方,如内因与不内外因,皆可选用,若外因伤风伤寒,传至阳明经腹胀,可以大
承气、杏子汤等,各见本门。湿胀,术附汤加茯苓、桂心;暑胀,黄龙丸,皆良药也。更有
香港脚支满,脾横泄,及五疸石水,妇人肠覃血膨,或单单腹胀之证,治之,各见本门。学人
当审详为治,无致混滥,失其机要也。
治疗腹部胀满且伴有发热,这是由于阳气并入阴分,导致阳实而阴虚。阳气过盛会产生体表发热,阴液不足会产生体内发热,脉象必然呈现浮数之象:浮脉主虚,数脉主热。因阴液亏虚不能正常宣通导引,虽然饮食如常,却导致腹部胀满,这被称为“热胀”。
方药组成:厚朴(用姜汁制后炒,一两)、甘草(炙烤)、大黄(蒸制,各三钱三分)、枳实(用麸皮炒后去掉瓤,半两)、桂心(一分)。
以上药物捣碎成粗散。每次服用四大钱,加水一盏半,生姜七片,大枣三个,煎煮至七分满,滤去药渣,饭前服用。如果伴有呕吐,加半夏一分;如果伴有腹泻,去掉大黄;如果寒象较重,加生姜十片一起煎煮。
治疗腹部虚性胀满,早晨症状缓解而傍晚加重,服用各种药物均无效,怕风,气机无法宣泄,腹部膨隆如鼓。
以上药物研细混合均匀。每次服用一大钱匕的量,用浓煎的薄荷汤调服;用酒送服效果更佳,不限时间。另一种方法是用干漆炒大烟(罂粟壳),根据患者虚实情况酌情使用,体质虚弱者不可使用。
治疗体虚老人饮用或食用生冷食物,多导致腹胀,胃脘部痞塞胀满,影响进食,或者出现刺痛、泄泻,气机痞塞滞闷。
方药组成:厚朴(去皮,细切)、甘草(切细)、生姜(洗净切片)、青州枣(切开,各等分)。
以上两种药材(注:原文此处可能有脱漏,通常指前文提到的几味药中的主要部分或特指某两味,结合上下文及后世整理,此处应理解为将厚朴、甘草与生姜、枣配合处理,但严格按原文翻译为“上二件”即指代前文列出的主要成分,实际操作中是将这些材料混合),捣碎处理得当,然后加入生姜,再次杵匀,取出,与大枣一同焙干,使其微微干燥,再放入锅内,用慢火炒至紫色,再次焙干并研成细末。每次服用一大钱,擦少许生姜,用沸水冲服,空腹服用,以见效为度。气味非常美好,兼能治愈疾病,又容易制作。
上述各方,如果是内因或不内外因导致的病症,都可以选用。如果是外因伤风伤寒,病邪传入阳明经导致腹胀,可以使用大承气汤、杏子汤等,详见各自章节。湿胀,可用术附汤加茯苓、桂心;暑胀,可用黄龙丸,都是良药。更有脚气病引起的支满,脾脏横逆导致的泄泻,以及五疸、石水,妇女肠覃、血膨,或者单纯的腹胀证候,治疗时请参见各自章节。学习者应当审慎详细地辨证施治,不要混淆滥投,以免错失关键要领。
Treat abdominal fullness accompanied by fever, which occurs when Yang merges into Yin, resulting in excess Yang and deficient Yin. Excess Yang generates external heat, while Yin deficiency generates internal heat; the pulse must be floating and rapid: a floating pulse indicates deficiency, and a rapid pulse indicates heat. Due to Yin deficiency failing to promote circulation and guidance, although diet remains normal, abdominal distension results, known as "Heat Distension."
Ingredients: Houpo (Magnoliae Officinalis Cortex), processed with ginger juice and stir-fried (1 liang); Gancao (Glycyrrhizae Radix et Rhizoma), honey-fried (3 qian 3 fen); Dahuang (Rhei Radix et Rhizoma), steamed (3 qian 3 fen); Zhishi (Aurantii Fructus), stir-fried with bran and de-seeded (0.5 liang); Guixin (Cinnamomi Ramulus) (1 fen).
Crush the above ingredients into coarse powder. Take 4 qian per dose, add 1.5 cups of water, 7 slices of Shengjiang (Zingiberis Rhizoma Recens), and 3 Zao (Jujubae Fructus). Decoct until reduced to 0.7 parts, strain, and take before meals. If vomiting is present, add Banxia (Pinelliae Rhizoma) 1 fen; if diarrhea is present, remove Dahuang; if cold signs are predominant, add 10 slices of Shengjiang for decoction.
Treat abdominal vacuous distension, where symptoms ease in the morning but tighten in the evening, unresponsive to various medications, accompanied by aversion to wind, inability to vent Qi, and bloating like a drum.
Ingredients: Hancanmian (Silkworm Cocoon Ash), burnt to ash (0.5 liang); Shexiang (Moschus) (0.5 qian, separately ground).
Grind the above ingredients finely and mix evenly. Take one large qian-bi (measure) per dose, mixed with strong decocted Bohe (Menthae Haplocalycis Herba) tea; taking it with wine is even better, at any time. Another method uses Ganqi (Dry Resin of Poppy) stir-fried with Dayan (Papaveris Fructus, i.e., Opium Poppy Shell), used according to the patient's deficiency or excess; it should not be used for those who are deficient.
Treat weak elderly patients who consume raw or cold foods/drinks, often leading to abdominal distension, epigastric stuffiness and fullness, hindering food intake, or causing stabbing pain, diarrhea, and Qi stagnation with oppression.
Ingredients: Houpo (Magnoliae Officinalis Cortex), peeled and finely cut; Gancao (Glycyrrhizae Radix et Rhizoma), finely cut; Shengjiang (Zingiberis Rhizoma Recens), washed and sliced; Qingzhou Zao (Jujubae Fructus), sliced (equal parts).
Take the aforementioned two items (Note: Text implies processing the main herbs together with ginger and dates), pound them appropriately, then add Shengjiang, pound again until uniform, remove, and bake together with Zao until slightly dry. Then place in a pot, stir-fry over slow fire until purple, bake dry again, and grind into fine powder. Take one large qian per dose, rub with a small amount of Shengjiang, brew with boiling water, take on an empty stomach, stopping when effective. The taste is excellent, it cures diseases, and is easy to prepare.
The above formulas can be selected for conditions caused by internal factors or non-internal/non-external factors. If external factors such as Wind-Cold invade and transmit to the Yangming Channel causing abdominal distension, use Dachengqi Tang (Major Order the Qi Decoction), Xingzi Tang, etc., see respective sections. For Damp Distension, use Shuzhu Fuzi Tang (Atractylodis Macrocephalae and Aconiti Lateralis Preparata Decoction) added with Fuling (Poria) and Guixin (Cinnamomi Ramulus); for Summerheat Distension, use Huanglong Wan (Yellow Dragon Pill), all are good medicines. Additionally, for Jiaoxie (Beriberi) causing chest/abdominal fullness, Pi Heng Xie (Spleen Transverse Diarrhea), Wu Dan Shi Shui (Five Jaundices and Stone Water), women's Changtan (Intestinal Mass) and Xue Peng (Blood Bloating), or simple abdominal distension, treatment details are found in their respective sections. Students should examine and treat carefully, avoiding confusion and misuse, so as not to miss the key essentials.