治因饥饱劳役损伤脾胃元气不足其脉弦洪缓而沉按之中之下得时一涩其证四肢满闷肢节
疼痛
难以屈伸身体沉重烦心不安忽肥忽瘦四肢懒倦口失滋味腹难舒伸大小便清利而数或上饮下便
或大便涩滞或夏月餐泄米谷不化或便后见血或便见白脓胸满短气咽膈不通痰唾稠粘口中沃沫
食入反出耳鸣耳聋目中流火视物昏花 肉红丝热壅头目不得安卧不思饮食并皆治之
橘皮(如腹中气不转运加木香一分如无此证不加)
黄柏(酒洗各二分)
升麻(此一味为上气不足胃气与脾气下流乃补上气从阴引阳)
柴胡(各三分)
人参(有嗽者去之)
炙甘草
苍术(各五分)
黄 (一钱)
如时显热躁是下元阴火蒸蒸然发也加生地黄(二分)
黄柏(三分)
如大便虚坐不得或大便了而不了腹中常常逼迫皆是血虚血涩加当归身(三分)无此证则去
之如
身体沉重虽小便数多亦加茯苓(二分)黄柏(三分)泽泻(五分)苍术(一钱)时暂从权而去湿也不
可常用兼足太阴已病其脉亦络于心中故显湿热相合而生烦乱
如胃气不和加汤洗半夏(五分)生姜(三片)有嗽者加生姜生地黄(二分)以制半夏之毒
如痰厥头痛非半夏不能除此足大阴脾邪所作也
如无以上证只服前药
上件锉如麻豆大都作一服水二大盏煎去渣稍热食远服之宁心绝虑静坐少语药必为效耳
如夏月须加白芍药(三分)
如春月腹中痛尤宜加
如恶热而渴或腹痛者更加芍药(五分)生黄芩(二分)如恶寒腹痛加中桂(三分)去黄芩谓之
桂枝芍药汤亦
于前药中加之
如冬月腹痛不可用芍药盖大寒之药也只加干姜(二分)或加半夏(五七分)以生姜少许制之
如秋冬之月胃脉四道为冲脉所逆胁下少阳脉二道而反上行名曰厥逆其证气上冲咽不得息
而
喘息有音不得卧加吴茱萸(五分至一钱汤洗去苦)观厥气多少而用之亦于前药中作一服服之
如夏月有此证为大热也此病随四时为寒热温凉也宜以
黄连(酒洗) 黄柏(酒浸) 知母(酒浸各等分)
上为细末熟汤为丸如梧桐子大每服一百丸或二百丸白汤送下空心服仍多饮热汤服毕少时
便以美
食压之使不令胃中停留直至下元以泻冲脉之邪也大抵治饮食劳倦所得之病乃虚劳七损证也常
宜以甘温平之甘多辛少是其治也
治疗因饥饱失调、劳役过度导致的脾胃元气损伤。其脉象弦、洪、缓,沉取时中下部偶尔出现涩象。症状表现为:四肢胀满闷塞,关节疼痛,难以屈伸;身体沉重,心烦不安,忽胖忽瘦,四肢倦怠无力,口不知味,腹部难以舒展,大小便清长而频数,或者上边饮水下边排泄(饮一溲一),或者大便涩滞不通,或者夏季进食后腹泻,米谷不化,或者便后见血,或者大便中带有白色脓液,胸部胀满,呼吸短促,咽喉膈部不通畅,痰涎粘稠,口中流涎沫,食物吃进去反而吐出,耳鸣耳聋,眼中感觉如火烧,视物昏花,眼睑红肿,热邪壅盛导致头目不得安宁,无法安卧,不思饮食。以上各种证候都以此方主治。
药物组成:陈皮(如果腹中气机运转不畅,加木香一分;如果没有此证,不加)、黄柏(酒洗,各二分)、升麻(这一味药用于补益上气不足,因为胃气和脾气下流,所以通过从阴引阳来补益上气)、柴胡(各三分)、人参(如果有咳嗽症状则去掉)、炙甘草、苍术(各五分)、黄芪(一钱)。
如果出现明显的燥热烦躁,这是下元阴火蒸腾发作的表现,加生地黄(二分)、黄柏(三分)。
如果大便虚坐努责排不出,或者大便排完了却觉得没排干净,腹中常常有紧迫逼迫感,这都是血虚血涩所致,加当归身(三分);没有此证则去掉。
如果身体沉重,虽然小便次数多也加茯苓(二分)、黄柏(三分)、泽泻(五分)、苍术(一钱),暂时权宜使用以祛湿,但不可常用,兼治足太阴脾经已病,其脉亦络于心中,故显现湿热相合而生烦乱。
如果胃气不和,加汤洗半夏(五分)、生姜(三片);有咳嗽的加生姜、生地黄(二分)以制约半夏的毒性。
如果没有以上证候,只服用前面的基础药物。
上述药物锉碎如麻豆大小,大致作为一服,用水两大盏煎煮,去渣,稍热时,在远离饭点的时间服用。需宁心绝虑,静坐少语,药必有效。
如果是夏季,须加白芍药(三分)。
如果是春季,腹中疼痛尤其适宜加白芍药。
如果恶热且口渴,或者腹痛者,更加白芍药(五分)、生黄芩(二分)。如果恶寒且腹痛,加肉桂(三分),去掉黄芩,这称为桂枝芍药汤,也可以在前药中加入。
如果是冬季腹痛,不可用芍药,因为它是大寒之药,只加干姜(二分)或加半夏(五至七分),用少许生姜来制约它。
如果是秋冬月份,胃脉四道被冲脉所逆,胁下少阳脉二道反而上行,名叫厥逆。其症状为气上冲咽喉,呼吸急促,喘息有声,不能平卧。加吴茱萸(五分至一钱,汤洗去苦味),观察厥气的多少来决定用量,也作为一服加入前药中服用。
如果是夏季有此证,属于大热。此病随四季变化而有寒热温凉的不同。适宜用黄连(酒洗)、黄柏(酒浸)、知母(酒浸,各等分)。
将上述药物研为细末,用熟汤泛丸,如梧桐子大。每次服用一百丸或二百丸,白开水送下,空腹服用,服药后仍多喝热汤,服完后稍顷以美食压住药力,使药力不令停留在胃中,直达下元以泻除冲脉的邪气。大抵治疗饮食劳倦所得的疾病,乃是虚劳七损之证,常宜用甘温之法平调,甘味药多辛味药少,这是治疗的法则。
Treatment for damage to the Spleen and Stomach Yuan Qi (Primary Qi) caused by irregular diet (overeating or fasting) and overexertion. The pulse is wiry, surging, slow, and when pressed deeply at the middle and lower positions, it occasionally presents a choppy quality. Symptoms include: fullness and oppression in the four limbs, pain in the joints with difficulty in flexion and extension; heaviness of the body, vexation and restlessness, fluctuating weight (sudden fatness or emaciation), lassitude of the four limbs, loss of taste in the mouth, inability to relax the abdomen, clear and frequent urination and defecation, or "drinking one part and urinating another" (polyuria after drinking), or constipation and dry stools, or summer diarrhea where rice and grains are undigested, or blood appearing after defecation, or white pus in the stool, chest fullness, shortness of breath, obstruction in the throat and diaphragm, thick and sticky phlegm and saliva, excessive salivation, regurgitation of food after eating, tinnitus and deafness, sensation of fire flowing in the eyes, blurred vision, redness of the eyelids, heat accumulation causing discomfort in the head and eyes, inability to lie down comfortably, anorexia. All these syndromes are treated with this formula.
Ingredients: Chenpi (Tangerine Peel); if qi stagnation in the abdomen prevents smooth transport, add Muxiang (Aucklandiae Radix) 1 fen; if not present, do not add. Huangbai (Phellodendri Cortex), wine-washed, 2 fen each. Shengma (Cimicifugae Rhizoma); this herb tonifies insufficient upper Qi, as the Stomach Qi and Spleen Qi sink, thus supplementing upper Qi by drawing Yang from Yin. Chaihu (Bupleuri Radix), 3 fen each. Renshen (Ginseng Radix et Rhizoma); remove if cough is present. Zhi Gancao (Prepared Licorice Root). Cangzhu (Atractylodis Rhizoma), 5 fen each. Huangqi (Astragali Radix), 1 qian.
If obvious heat and irritability appear, indicating steaming emission of ministerial fire from the lower origin, add Shengdihuang (Rehmanniae Radix) 2 fen and Huangbai (Phellodendri Cortex) 3 fen.
If there is tenesmus with empty straining, or a sensation of incomplete evacuation with constant abdominal urgency, this indicates Blood deficiency and Blood stasis; add Dangguishen (Radix Angelicae Sinensis, root portion) 3 fen; remove if not present.
If the body feels heavy, even with frequent urination, add Fuling (Poria), 2 fen; Huangbai (Phellodendri Cortex), 3 fen; Zexie (Alismatis Rhizoma), 5 fen; Cangzhu (Atractylodis Rhizoma), 1 qian. Use temporarily to resolve dampness, but do not use long-term, as the Taiyin Spleen channel is already diseased, and its pulse connects to the Heart, manifesting as vexation arising from the combination of Damp-Heat.
If Stomach Qi is disharmonious, add Banxia (Pinelliae Rhizoma), washed with decoction, 5 fen; Shengjiang (Zingiberis Rhizoma Recens), 3 slices. If cough is present, add Shengjiang (Zingiberis Rhizoma Recens) and Shengdihuang (Rehmanniae Radix) 2 fen to counteract the toxicity of Banxia.
If headache due to Phlegm-Jue (Phlegm-induced collapse of Yang) occurs, only Banxia (Pinelliae Rhizoma) can eliminate it, as this is caused by pathogenic factors of the Foot-Taiyin Spleen.
If none of the above symptoms are present, take only the preceding base herbs.
The above ingredients are chopped like hemp seeds, generally prepared as one dose. Boil in two large bowls of water, strain, and drink slightly warm, far from meal times. Maintain mental tranquility, avoid excessive speech, and the medicine will surely be effective.
In summer, add Baishao (Paeoniae Radix Alba) 3 fen.
In spring, if abdominal pain occurs, adding Baishao (Paeoniae Radix Alba) is particularly suitable.
If there is aversion to heat with thirst, or abdominal pain, add more Baishao (Paeoniae Radix Alba) 5 fen and Sheng Huangqin (Scutellariae Radix) 2 fen. If there is aversion to cold with abdominal pain, add Rougui (Cinnamomi Cortex) 3 fen and remove Huangqin (Scutellariae Radix); this is called Guizhi Shaoyao Tang (Cinnamon Twig and Peony Decoction), which can also be added to the previous formula.
In winter, if abdominal pain occurs, Baishao (Paeoniae Radix Alba) should not be used as it is a very cold herb; instead, add Ganjiang (Zingiberis Radix) 2 fen, or add Banxia (Pinelliae Rhizoma) 5-7 fen, controlled with a little Shengjiang (Zingiberis Rhizoma Recens).
In autumn and winter months, if the four pathways of the Stomach pulse are reversed by the Chong Mai (Penetrating Vessel), and the two pathways of the Shaoyang pulse under the hypochondrium ascend contrary to their normal direction, it is named Jue Ni (Jue Reversal). Symptoms include Qi rushing up to the throat, difficult breathing, audible wheezing, and inability to lie flat. Add Wuzhuyu (Evodiae Fructus) 5 fen to 1 qian, washed with decoction to remove bitterness. Adjust the dosage based on the degree of Jue Qi. Prepare as one dose mixed with the previous herbs.
If this syndrome occurs in summer, it indicates severe Heat. This disease varies in Cold, Heat, Warmth, and Coolness according to the seasons. It is appropriate to use Huanglian (Coptidis Rhizoma), wine-washed; Huangbai (Phellodendri Cortex), wine-soaked; and Zhimu (Anemarrhenae Rhizoma), wine-soaked, in equal parts.
Grind the above into fine powder, form pills with hot water, size of Sophora seeds. Take 100 or 200 pills per dose, with plain warm water, on an empty stomach. Drink plenty of hot water after ingestion. Shortly after taking the medicine, eat some food to prevent the medicine from lingering in the Stomach, allowing it to reach the lower origin to drain pathogenic factors from the Chong Mai (Penetrating Vessel). Generally, treating diseases caused by dietary irregularities and overexertion involves deficiency-fatigue and the seven damages syndromes. One should commonly use sweet and warm methods to balance them, with more sweet herbs and fewer pungent herbs, which is the therapeutic principle.