瓜蒂(熬黄) 赤小豆(各一分) 上二味,各别捣筛为散,已合治之,取一钱匕。以香豉一合,用热汤七合,
煮作稀糜,去渣,和散,温顿服之。不吐者,少少加,得快吐乃止,诸亡血虚家,不可与瓜蒂散。此即
《论》中所云吐法也。栀子豉汤治虚烦,非专引吐,此方则专于引吐而已。
病如桂枝证,头不痛,项不强,寸脉微浮,胸中痞硬,气上冲咽喉,不得息者,此为胸中有寒也,
寒必兼饮。当吐之,在上者越之。宜瓜蒂散。《本草》瓜蒂∶病在胸腹中,皆吐下之。
病患手足厥冷,脉乍紧者,邪结在胸中,所以阳气不能四达。心中满而烦,饥不能食者,病在胸中,
当须吐之,宜瓜蒂散。
吴茱萸(一升,洗) 人参(三两) 生姜(六两,切) 大枣(十二枚,擘) 上四味,以水七升,煮取二升,
去渣,温服七合,日三服。
食谷欲呕者,必食谷而呕,受病在纳谷之处,与干呕迥别。属阳明也,吴茱萸汤主之。得汤反剧者,
属上焦也。上焦指胸中,阳明乃中焦也。
少阴病,吐利,手足逆冷,烦躁欲死者,吴茱萸汤主之。此胃气虚寒之症。
干呕吐涎沫,吐涎沫,非少阳之干呕。然亦云干呕者,谓不必食谷而亦呕也,头痛者,阳明之脉上于
头。吴茱萸汤主之。此胃中有寒饮之症。
瓜蒂(炒至黄色) 赤小豆(各取一分) 以上两味药,分别捣碎并过筛成散剂,混合均匀后,取一钱匕的量。用香豉一合,加入热水七合,煮成稀粥状,去掉药渣,将药散与药汁混合,温服,一次性喝完。如果未引起呕吐,则逐渐少量增加剂量,直到迅速引发呕吐为止。凡是失血患者及体质虚弱者,不可服用瓜蒂散。这就是《伤寒论》中所说的吐法。栀子豉汤治疗虚烦,并非专门用于催吐,而本方则是专门用于催吐的。
病症类似桂枝证,但头部不痛,项部不强硬,寸脉微浮,胸中痞塞坚硬,气向上冲撞咽喉,导致呼吸不畅的,这是胸中有寒邪所致,寒邪必然兼夹痰饮。应当使用吐法,“病位在上者,通过涌吐使其排出”。适宜使用瓜蒂散。《本草》记载:瓜蒂主治病在胸腹中的病症,均通过吐下法治疗。
患者手足厥冷,脉搏突然变得紧实的,是邪气结聚在胸中,因此阳气不能通达四肢。心中胀满且烦躁,饥饿却无法进食的,病位在胸中,应当使用吐法,适宜使用瓜蒂散。
吴茱萸(一升,洗净) 人参(三两) 生姜(六两,切片) 大枣(十二枚,掰开) 以上四味药,用水七升,煮取二升药液,去掉药渣,温服七合,每日服用三次。
进食后想要呕吐的,一定是吃了东西才呕吐,病变部位在受纳食物的地方,这与干呕截然不同。属于阳明经病,由吴茱萸汤主治。如果服用汤药后病情反而加重,说明病位在上焦。上焦指胸中,阳明经属于中焦。
少阴病,出现呕吐、腹泻,手足逆冷,烦躁不安甚至痛苦欲死的,由吴茱萸汤主治。这是胃气虚寒的症状。
干呕并吐出清稀涎沫,这种吐涎沫不属于少阳病的干呕。之所以也称为干呕,是指不一定进食也会呕吐。伴有头痛的,因为阳明经脉上行至头部。由吴茱萸汤主治。这是胃中有寒饮的症状。
Genti (Gardeniae Fructus, processed until yellow) and Chixiaodou (Adzuki Bean, each one fen). The above two herbs are separately pounded and sifted into powder, then mixed. Take one qianbi (a traditional measure of volume/weight) of the mixture. Use Xiangchi (Perilla Seed, one he) boiled in hot water (seven he) to make a thin porridge. Strain out the dregs, mix with the powder, and take warm in one dose. If vomiting does not occur, increase the dose slightly at a time until rapid vomiting is achieved. Patients who have lost blood or are constitutionally deficient must not be given Gudi San. This is the emetic method mentioned in the *Treatise on Cold Damage*. Zhizi Chi Tang (Gardenia and Perilla Decoction) treats deficiency vexation but is not specifically for inducing vomiting; this formula is specifically for inducing vomiting.
Symptoms resembling Guizhi Tang syndrome, but without headache or neck stiffness, with a slightly floating pulse at the cun position, chest oppression and hardness, qi rushing up to the throat causing dyspnea, indicates cold pathogen in the chest, which must involve fluid retention. Emesis should be used: "For pathogens located above, disperse them by vomiting." Gudi San is appropriate. *Bencao* states: For diseases in the chest and abdomen, treat by vomiting or purging.
Patients with cold limbs and sudden tight pulse indicate evil Qi knotting in the chest, preventing Yang Qi from reaching the four extremities. Fullness and vexation in the heart, hunger but inability to eat, indicate the disease is in the chest. Emesis is required; Gudi San is appropriate.
Wuzhuyu (Evodia Fruit, one sheng, washed), Renshen (Ginseng Root, three liang), Shengjiang (Fresh Ginger, six liang, sliced), Dazao (Jujube, twelve pieces, broken open). The above four herbs are boiled in seven sheng of water to obtain two sheng of decoction. Strain out the dregs. Take seven he warm, three times a day.
Those who desire to vomit after eating food will definitely vomit after eating; the pathology is in the site of receiving grain, distinct from gan ou (dry retching). This belongs to the Yangming channel; Wuzhuyu Tang is the primary treatment. If symptoms worsen after taking the decoction, it belongs to the Upper Jiao (Upper Burner). The Upper Jiao refers to the chest, while Yangming belongs to the Middle Jiao (Middle Burner).
Shaoyin disease presenting with vomiting and diarrhea, cold limbs, and severe irritability bordering on death is treated with Wuzhuyu Tang. This is a symptom of Stomach Qi deficiency and cold.
Dry retching with expulsion of clear saliva/phlegm. Expelling saliva/phlegm is not dry retching of Shaoyang. However, it is called dry retching because vomiting occurs even without eating. With headache, as the Yangming meridian ascends to the head. Wuzhuyu Tang is the primary treatment. This is a symptom of cold-fluid retention in the Stomach.