某 无形气伤。热邪蕴结。不饥不食。岂血分腻滞可投。口甘一症。内经称为脾瘅。中焦困不转
运可知。（中虚伏热）
川连 淡黄芩 人参 枳实 淡干姜 生白芍
某 口甜。是脾胃伏热未清。宜用温胆汤法。
川连 山栀 人参 枳实 花粉 丹皮 橘红 竹茹 生姜
口甘一症。内经谓之脾瘅。此甘。非甘美之甘。瘅即热之谓也。人之饮食入胃。赖脾真以运
之。命阳以腐之。譬犹造酒蒸酿者然。倘一有不和。肥甘之疾顿发。五液清华。失其本来之
真味。则淫淫之甜味。上泛不已也。胸脘必痞。口舌必腻。不饥不食之由。从此至矣。内经设
一兰草汤。其味辛。足以散结。其气清。足以化浊。除陈解郁。利水和营。为奇方之祖也。夹暑
夹泾之候。每兼是患。以此为君。参以苦辛之胜。配合泻心等法。又如胃虚谷少之人。亦有
是症。又当宗大半夏汤。及六君子法。远甘益辛可也。（邵新甫）
脾瘅症。经言因数食甘肥所致。盖甘性缓。肥性腻。使脾气遏郁。致有口甘内热中满之患。
故云治之以兰。除陈气也。陈气者。即甘肥酿成陈腐之气也。夫兰草即为佩兰。俗名为省
头草。妇人插于髻中。以辟发中油秽之气。其形似马兰而高硕。其气香。其味辛。其性凉。
亦与马兰相类。用以醒脾气。涤甘肥也。今二案中。虽未曾用。然用人参以助正气。余用苦
辛寒以开气泄热。枳实以理气滞。亦祖兰草之意。即所谓除陈气也。此症久延。即化燥热。
转为消渴。故前贤有膏粱无厌发痈疽。热燥所致。淡薄不堪生肿胀。寒湿而然之论。余于
甘肥生内热一症。悟出治胃寒之一法。若贫人淡薄茹素。不因外邪。亦非冷冻饮料停滞。其本
质有胃寒症者。人皆用良姜丁香荜茇吴萸干姜附子等以温之。不知辛热刚燥能散气。
徒使胃中阳气。逼而外泄。故初用似效。继用则无功。莫若渐以甘肥投之。或稍佐咸温。或
佐酸温。凝养胃阳。使胃脂胃气日浓。此所谓药补不如食补也。又有肾阳胃阳兼虚者。曾
见久服鹿角胶而愈。即此意也。未识高明者以为然否。（华岫云）
某患者，无形之气受损。热邪蕴结于内。导致没有饥饿感且不想进食。这难道是血分中腻滞之证可以投药治疗的吗？口中有甜味这一症状，《内经》称之为脾瘅。可知中焦困阻，无法正常转运。（这是中气虚弱兼有伏热的表现）
黄连 淡黄芩 人参 枳实 淡干姜 生白芍
另一位患者，口中发甜。这是脾胃中潜伏的热邪尚未清除。应当采用温胆汤的治法。
黄连 山栀 人参 枳实 花粉 丹皮 橘红 竹茹 生姜
口中有甜味这一症状，《内经》称之为脾瘅。这种“甘”，不是指甘美的味道。“瘅”就是热的意思。人的饮食进入胃中，依赖脾的真气来运化，依靠命门的阳气来腐熟。就像酿酒蒸酿一样。如果稍有不和，过食肥甘厚味导致的疾病就会立刻发作。五液（精、血、津、液、汗）的清华之气，失去了本来的真味，于是淫淫然的甜味，不断上泛。胸部和脘部必然痞塞，口舌必然腻浊。没有饥饿感且不想进食的原因，由此产生。《内经》设立了一个兰草汤，它的味道辛，足以散结；它的气清，足以化浊。能去除陈腐、解开郁结，利水并调和营卫，是奇方中的祖方。夹杂暑湿或泾渭（此处指湿热混杂）的情况，常常兼有此患。以此方为君药，参以苦辛胜湿的方法，配合泻心汤等治法。又如胃虚谷少的人，也有这种症状，又应当遵循大半夏汤及六君子汤的法度，远离甘味而增益辛味是可以的。（邵新甫评注）
脾瘅症，《内经》说因为经常食用甘肥食物所致。大概甘性缓，肥性腻，使脾气遏郁，导致出现口甘、内热、中满的病患。所以说用兰草治疗，是为了去除陈腐之气。所谓陈气，就是甘肥酿造成的陈腐之气。兰草就是佩兰，俗名省头草。妇女插在发髻中，用来辟除头发中的油秽之气。它的形状像马兰但更高大硕壮，气味香，味道辛，性质凉。也与马兰相似。用它来醒脾气，涤除甘肥之腻。在刚才的两个医案中，虽然未曾直接使用兰草，但是用人参来助正气，其余使用苦辛寒的药物来开气泄热，用枳实来理气滞，也是遵循兰草的意思，即所谓的去除陈气。此症拖延日久，就会化为燥热，转为消渴病。所以前贤有论断：膏粱无厌（长期享用油腻精细食物）会导致痈疽，这是由热燥引起的；淡薄不堪（长期食用清淡粗劣食物）会生肿胀，这是由寒湿造成的。我从甘肥生内热这一病症中，悟出了一条治疗胃寒的方法。如果是穷人长期食用清淡素食，不是因为外邪侵袭，也不是因为冷冻饮料停滞，其本质有胃寒症的人，人们都用良姜、丁香、荜茇、吴萸、干姜、附子等药物来温补。却不知道辛热刚燥的药物会耗散气机，只会使胃中的阳气被逼而外泄。所以初用时似乎有效，继用则无功。不如逐渐给予甘肥食物，或者稍加咸温或酸温之物，凝养胃阳，使胃脂和胃气日渐浓厚。这就是所说的药补不如食补。又有肾阳和胃阳都兼有虚损的人，曾见有人久服鹿角胶而痊愈，就是这个道理。不知高明者是否认为正确。（华岫云评注）
A certain patient suffered from injury to formless Qi. Heat pathogen accumulated and knotted within, resulting in a lack of appetite and refusal to eat. Could this be treated by targeting stagnation in the Blood level? The symptom of a sweet taste in the mouth is referred to as Pi Dan (Spleen Piquancy) in the *Nei Jing* (Inner Canon). It can be understood that the Middle Jiao (Middle Burner) is obstructed and fails to transport normally. (This indicates deficiency of Zhong Qi [Middle Jiao Qi] with latent heat.)
Coptidis Rhizoma (Chuanlian), Scutellariae Radix (Dan Huangqin), Ginseng Radix et Rhizoma (Renshen), Aurantii Fructus Immaturus (Zhishi), Zingiberis Rhizoma Recens (Dan Ganjiang), Paeoniae Radix Alba (Sheng Baishao)
Another patient presented with a sweet taste in the mouth. This indicates that latent heat in the Spleen and Stomach has not yet been cleared. The method of Wendan Tang (Phlegm-Resolving Decoction) should be employed.
Coptidis Rhizoma (Chuanlian), Gardeniae Fructus (Shanzhi), Ginseng Radix et Rhizoma (Renshen), Aurantii Fructus Immaturus (Zhishi), Platycodonis Radix (Huafen), Moutan Cortex (Danpi), Citri Reticulatae Pericarpium (Juhong), Bambusae Mesocarp (Zhuru), Zingiberis Rhizoma Recens (Shengjiang)
The symptom of a sweet taste in the mouth is called Pi Dan (Spleen Piquancy) in the *Nei Jing*. This "sweetness" does not refer to a pleasant flavor. "Dan" means heat. When food enters the Stomach, it relies on the true Qi of the Spleen to transform and transport, and on the Yang Qi of the Mingmen (Gate of Life) to rot and ripen, much like the process of brewing wine. If there is any disharmony, diseases caused by rich and sweet foods will manifest immediately. The pure essence of the Five Fluids (Wu Ye) loses its original true flavor, causing an incessant sweet taste to float upward. The chest and epigastrium will inevitably feel distended and blocked, and the mouth and tongue will feel greasy. The cause of lack of appetite and refusal to eat arises from this. The *Nei Jing* established Lancao Tang (Eupatorium Decoction), which has a pungent flavor sufficient to dissipate knots, and a clear qi sufficient to resolve turbidity. It removes stale accumulation, resolves depression, promotes urination, and harmonizes Ying (Nutritive) Qi. It is the ancestral formula among miraculous prescriptions. In cases complicated by Summerheat or Damp-Heat, this condition often coexists. Using this as the sovereign herb, combined with bitter-pungent methods to overcome dampness, and paired with Xiexin Tang (Drain the Epigastrium Decoction) methods. Furthermore, patients with deficient Stomach Qi and insufficient grain intake may also have this symptom; in such cases, one should follow the principles of Banxia Houpo Tang (Pinellia and Magnolia Bark Decoction) or Liujunzi Tang (Six Gentlemen Decoction), avoiding sweet flavors and augmenting pungent ones is appropriate. (Commentary by Shao Xinpu)
Pi Dan (Spleen Piquancy syndrome), as stated in the classics, is caused by frequent consumption of sweet and fatty foods. Sweetness is slow and cloying, while fatiness is greasy and obstructive, causing Spleen Qi to become depressed and leading to symptoms of sweet taste in the mouth, internal heat, and abdominal fullness. Therefore, it is said that treating with Eupatorium (Lancao) removes stale Qi. Stale Qi refers to the stale and rotten Qi brewed by sweet and fatty foods. Eupatorium is Peilan (Eupatorium fortunei), commonly known as Shengtoucao. Women insert it into their hairpins to ward off the oily and foul odor of hair. Its shape resembles Malan (Kalimeris indica) but is taller and sturdier; its aroma is fragrant, its taste pungent, and its nature cool. It is similar to Malan. It is used to awaken Spleen Qi and cleanse the greasiness of sweet and fatty foods. Although these two case records did not use Eupatorium directly, using Ginseng to assist righteous Qi, employing bitter-pungent-cold herbs to open Qi and drain heat, and using Aurantii Fructus Immaturus to regulate Qi stagnation, all follow the intent of Eupatorium, i.e., removing stale Qi. If this condition persists for a long time, it transforms into dryness-heat and evolves into Xiaoke (Wasting-Thirst). Thus, ancient sages argued: excessive indulgence in rich and fine foods leads to carbuncles and sores due to heat-dryness; while extreme poverty and bland diets lead to edema due to cold-dampness. From the syndrome of internal heat generated by sweet and fatty foods, I deduced a method for treating Stomach Cold. For poor people who consume bland vegetarian diets, without external pathogenic invasion or stagnation from cold drinks, if they inherently suffer from Stomach Cold, people usually use Alpiniae Officinarum Rhizoma (Liangjiang), Symplocos Racemosae Fructus (Dingxiang), Piperis Longi Fructus (Bibo), Evodiae Fructus (Wuyu), Zingiberis Rhizoma (Ganjiang), and Aconiti Lateralis Radix Praeparata (Fuzi) to warm them. They do not realize that pungent-hot and rigid-dry herbs disperse Qi, merely forcing the Yang Qi of the Stomach to leak outward. Thus, initial use seems effective, but subsequent use yields no results. It is better to gradually administer sweet and fatty foods, or slightly add salty-warm or sour-warm substances to consolidate Stomach Yang, making Stomach fluids and Qi thick day by day. This is what is meant by "food supplementation is superior to drug supplementation." There are also cases where both Kidney Yang and Stomach Yang are deficient; I have seen patients cured after long-term consumption of Cervi Cornu Colla (Deer Antler Glue). This illustrates the same principle. I wonder if experts agree. (Commentary by Hua Xiuyun)