调脾抑火汤 治脾气不足。心中不时嘈杂。
白茯苓 黄连 山栀仁 白术(各二钱) 陈皮 黄芩 甘草(各一钱) 水煎不拘时服。
又方 治心血少。胃口嘈杂。不时索食。
黄连(姜汁炒) 当归 人参 白术(土炒各二钱) 龙眼肉五个。煎服。
诸逆冲上。皆属于火。古以为寒。恐非也。治法须辨有余不足而治。
浮而缓者易治。急者难治。
橘皮竹茹汤 治大病后。中气不足。呃逆不已。脉来虚细。
人参 陈皮 竹茹 甘草(各二钱) 枣五枚。生姜十片。煎服。
解毒汤 治痰火相搏。呃逆不住。(方见伤寒门)
丁香竹茹汤 治中焦气塞。下焦呃逆。
柿蒂 陈皮 生茹(各二钱) 丁香(五枚) 生姜五片。煎服。
又方 治妇人产后发呃。
黄柏 当归 知母 陈皮(各二钱) 生地 川芎 竹茹 白芍(各一钱二分) 生姜三片
腹位于人之中。而统于脾胃。水谷之府也。有寒客之。则阻不行。有热内生。郁而不散。
有食
皆能作痛。又有虫痛。暑痛。疝痛。积聚痛。绞肠痛。痢痛。肠痈痛。种种不一。皆宜辨之
。绵绵痛而无增洞。以热手熨之稍止。脉细沉而迟。小便清白自利者寒也。时痛时止。痛处
亦热手不可近。日干舌燥。小便赤涩。大便闭。或肛门如烧者火也。胸膈饱闷。以手重按愈
痛。欲大便利后。则痛减者食也。痛有常处。遇夜益甚。腹膨小便利。脉涩者。死血也。阻
滞气道小便不利。其脉滑者痰也。痛连两胁。或攻注腰背。其脉弦者怒也。若平素慎于饮食
。而视其肢体瘦弱。又不饱闷。但偎偎作痛。如细筋牵引者。血虚也。若肚腹常觉空虚。似
饿非饿。翕翕作痛。呼吸如无气力者。气虚也。面黄肌瘦。肚大青筋。往来绞痛。痛定能食
面生白斑。唇白毛竖。呕吐清水虫也。暑痛伤暑。积聚痛有形可按。疝痛引丸。绞肠沙痛。
不吐不泻。痢痛后重。肠痈痛。脐生疮。小便如淋。大概大腹痛。属太阴。多食积外感。脐
腹痛。俱少阴。多积热痰火。小腹痛。属厥阴。多瘀血及痰。与溺涩脐下。如此推之。则寒
热虚实朗明矣。
凡是嘈杂(胃中似饥非饥、似痛非痛、懊侬不安的感觉)都是由于心和脾两经的虚火发动引起的。两手寸部和关部脉象呈现弦滑之象,就是这种证候的表现。
调脾抑火汤:治疗脾气不足。心中不时出现嘈杂感。
白茯苓、黄连、山栀仁、白术(各二钱)、陈皮、黄芩、甘草(各一钱),用水煎煮,不拘时间服用。
另一个方子:治疗心血亏少。胃口嘈杂,不时想要进食。
黄连(用姜汁炒制)、当归、人参、白术(用土炒制,各二钱)、龙眼肉五个。煎服。
各种气逆冲上的病证,都归属于火。古人认为是寒证,恐怕是不对的。治疗方法必须辨别是实证还是虚证来进行治疗。
脉象浮而缓的容易治疗;脉象急迫的难以治疗。
橘皮竹茹汤:治疗大病之后,中气不足,呃逆不止。脉象虚细。
人参、陈皮、竹茹、甘草(各二钱)、大枣五枚、生姜十片。煎服。
解毒汤:治疗痰与火相互搏结,呃逆不停。(此方见《伤寒门》章节)
丁香竹茹汤:治疗中焦气机堵塞,下焦呃逆。
柿蒂、陈皮、生竹茹(各二钱)、丁香(五枚)、生姜五片。煎服。
另一个方子:治疗妇女产后发生呃逆。
黄柏、当归、知母、陈皮(各二钱)、生地、川芎、竹茹、白芍(各一钱二分)、生姜三片。
腹部位于人体中部,由脾胃统管,是水谷汇聚的府库。如果有寒气客居其中,就会阻碍气机运行;如果有热邪内生,就会郁结而不能发散。
有食积停滞
都能引起疼痛。还有虫痛、暑痛、疝痛、积聚痛、绞肠痛、痢疾痛、肠痈痛等,种类繁多,不一而足,都应该仔细辨别。
疼痛绵绵不断且没有剧烈洞穿感的,用手热敷后稍微缓解,脉象细沉而迟,小便清白通畅的是寒证。时痛时止,疼痛部位即使热敷也不能靠近,口干舌燥,小便赤涩,大便闭塞,或者肛门感觉像火烧一样的是火证。胸膈饱闷,用手重按时疼痛加剧,想要解大小便,排便后疼痛减轻的是食积证。疼痛位置固定,夜间加重,腹部膨隆但小便通利,脉象涩滞的是瘀血证。阻滞气道导致小便不利,脉象滑利的是痰证。疼痛牵连两侧胁肋,或者攻窜注连腰背部,脉象弦紧的是因愤怒所致的情志病。如果平时饮食谨慎,但是肢体瘦弱,又不觉得饱闷,只是隐隐作痛,像细筋牵引一样的,是血虚证。如果肚腹常觉空虚,似饿非饿,隐隐作痛,呼吸显得无力的是气虚证。面色发黄肌肉消瘦,肚子大且有青筋暴露,往来绞痛,疼痛停止后能进食,面部出现白斑,嘴唇发白,毫毛竖起,呕吐清水的是虫证。暑痛是伤于暑邪,积聚痛是有形之物可按摸到,疝痛牵引睾丸,绞肠沙痛是不吐不泻,痢痛伴有里急后重,肠痈痛则是脐部生疮,小便如同淋证一般。大致来说,大腹痛属于太阴经,多因食积和外感引起;脐腹痛属于少阴经,多因积热和痰火引起;小腹痛属于厥阴经,多因瘀血及痰湿,以及小便涩滞引起。按照这样推究,那么寒、热、虚、实的病机就明朗了。
All cases of *zaocha* (a sensation of hunger mixed with discomfort, neither true hunger nor pain, accompanied by a feeling of restlessness) are caused by the activation of deficient fire in the Heart and Spleen meridians. This is indicated by a wiry and slippery pulse at the Cun (inch) and Guan (middle) positions on both wrists.
**Tiaopi Huohuo Tang (Spleen-Regulating and Fire-Suppressing Decoction)**: Treats insufficient Spleen Qi, characterized by intermittent sensations of *zaocha* in the chest/heart area.
Ingredients: Bai Fuling (Poria), Huanglian (Coptis Rhizome), Shanzhiren (Gardenia Seed), Baizhu (Atractylodes Macrocephala Rhizome) [each 2 qian]; Chenpi (Citrus Reticulata Peel), Huangqin (Scutellaria Root), Gancao (Licorice Root) [each 1 qian]. Decoct in water and take at any time.
Another prescription: Treats insufficient Heart Blood, characterized by gastric *zaocha* and frequent cravings for food.
Ingredients: Huanglian (Coptis Rhizome, stir-fried with ginger juice), Danggui (Angelica Sinensis Root), Renshen (Ginseng Radix), Baizhu (Atractylodes Macrocephala Rhizome, soil-stir-fried) [each 2 qian]; Longyanrou (Longan Aril) [5 pieces]. Decoct and take.
All conditions involving rebellious Qi rushing upward belong to Fire. The ancients considered them Cold patterns, which is likely incorrect. Treatment methods must distinguish between excess and deficiency before applying therapy.
If the pulse is floating and moderate, it is easy to treat; if the pulse is rapid/tense, it is difficult to treat.
**Jupi Zhuru Tang (Tangerine Peel and Bamboo Shavings Decoction)**: Treats persistent hiccups due to insufficient Middle Qi after a severe illness, with a deficient and fine pulse.
Ingredients: Renshen (Ginseng Radix), Chenpi (Citrus Reticulata Peel), Zhuru (Bamboo Shavings), Gancao (Licorice Root) [each 2 qian]; Jujube (Chinese Date) [5 pieces], Shengjiang (Fresh Ginger Slice) [10 slices]. Decoct and take.
**Jiedu Tang (Detoxifying Decoction)**: Treats persistent hiccups caused by the interaction of Phlegm and Fire. (See the *Shanghan Men* chapter for the formula details).
**Dingxiang Zhuru Tang (Clove and Bamboo Shavings Decoction)**: Treats hiccups originating from the Lower Jiao due to Qi blockage in the Middle Jiao.
Ingredients: Shidi (Persimmon Calyx), Chenpi (Citrus Reticulata Peel), Shengzhuru (Raw Bamboo Shavings) [each 2 qian]; Dingxiang (Caryophylli Flos) [5 pieces], Shengjiang (Fresh Ginger Slice) [5 slices]. Decoct and take.
Another prescription: Treats hiccups occurring postpartum in women.
Ingredients: Huangbai (Phellodendron Bark), Danggui (Angelica Sinensis Root), Zhimu (Anemarrhena Rhizome), Chenpi (Citrus Reticulata Peel) [each 2 qian]; Shengdi (Rehmannia Root), Chuanxiong (Ligusticum Chuanxiong Rhizome), Zhuru (Bamboo Shavings), Baishao (White Peony Root) [each 1.2 qian], Shengjiang (Fresh Ginger Slice) [3 slices].
The Abdomen is located in the center of the human body and is governed by the Spleen and Stomach; it is the residence of water and grain. If Cold pathogens invade, they obstruct circulation; if Heat arises internally, it stagnates without dispersing.
Food retention
can all cause pain. There are also worm pain, summerheat pain, hernia pain, accumulation/mass pain, intestinal cramping pain, dysentery pain, and appendicitis pain, among many others. All require differentiation.
Continuous dull pain without sharp piercing sensations, which alleviates slightly with hot compresses, accompanied by a fine, deep, and slow pulse, clear and profuse urination, indicates a Cold pattern. Intermittent pain where the painful area cannot tolerate heat, dry mouth and tongue, dark and scanty urination, constipation, or a burning sensation in the anus, indicates a Fire pattern. Chest and epigastric fullness and oppression, where pain worsens with heavy pressure, and pain alleviates after defecation or urination, indicates Food retention. Pain localized to a specific area, worsening at night, with abdominal distension but normal urination, and a choppy pulse, indicates Blood stasis. Obstruction of Qi mechanism leading to difficult urination, with a slippery pulse, indicates Phlegm. Pain radiating to both hypochondriac regions or shooting into the lower back, with a wiry pulse, indicates emotional anger. If one usually eats cautiously, yet the limbs are emaciated, without fullness or oppression, but experiencing only lingering pain as if pulled by fine threads, this indicates Blood deficiency. If the abdomen constantly feels empty, resembling hunger but not quite, with lingering pain and weak respiration, this indicates Qi deficiency. Yellowish complexion with emaciation, large abdomen with visible blue veins, alternating colicky pain, ability to eat when pain subsides, white spots on the face, pale lips, erect hair, and vomiting of clear fluid indicate Worm infestation. Summerheat pain results from Summerheat injury; accumulation/mass pain presents as palpable masses; hernia pain radiates to the testicles; intestinal cramping pain occurs without vomiting or diarrhea; dysentery pain is accompanied by tenesmus; appendicitis pain involves sores around the umbilicus and urinary symptoms resembling strangury. Generally, upper abdominal pain belongs to the Taiyin stage, often due to food retention and external contraction; periumbilical pain belongs to the Shaoyin stage, often due to accumulated heat and phlegm-fire; lower abdominal pain belongs to the Jueyin stage, often due to blood stasis, phlegm, and difficult urination. By reasoning in this manner, the patterns of Cold, Heat, Deficiency, and Excess become clear.