治伤肉湿面辛辣味浓之物填塞闷乱不快
枳实(麸炒五钱) 黄连(去须酒洗) 大黄(湿纸裹煨) 神曲(炒) 橘皮 白术(各一两)
黄芩(二两)
上为极细末汤浸蒸饼为丸如绿豆一倍大每服五十丸白汤下临时量所伤多少加减服之
治伤生冷硬物心腹满闷疼痛
巴豆霜(五分) 木香(二钱) 升麻 柴胡(各三钱) 草豆蔻(面裹煨熟用仁) 香附子(
炒各五钱) 神曲(炒黄色) 石三棱(去皮煨) 京三棱(煨各一两)
上为细末汤浸蒸饼为丸如绿豆一倍大每服一二十丸温白汤下量所伤多少加减服之
治伤豆粉湿面油腻之物
白矾(枯三钱) 黄芩(五钱) 橘皮(七钱) 神曲(炒黄色) 半夏(汤洗七次) 白术(各
一两) 枳实(麸炒黄色一两一钱)
上为极细末汤浸蒸饼为丸如绿豆大每服三五十丸白汤下素食多用干姜故加黄芩以泻之
治秋冬伤寒冷物胃脘当心而痛上肢两胁咽膈不通
炒盐(五分) 干生姜 青皮 橘皮(各二钱) 麦 面(炒黄色) 生黄芩(冬月不用) 半
夏
(汤洗七次) 神曲(炒各五钱) 草豆蔻(面裹煨去皮取仁) 白术(各一两) 枳实(麸炒二两)
上为极细末汤浸蒸饼为丸如绿豆大每服五十丸白汤下
六元政纪论云太阴所至为中满太阴所至为蓄满诸湿肿满皆属脾土论云脾乃阴中之太阴同
湿土
之化脾湿有余腹满食不化天为阳为热主运化也地为阴为湿主长养也无阳则阴不能生化故云脏
寒生满病调经篇云因饮食劳倦损伤脾胃始受热中未传寒中皆由脾胃之气虚弱不能运化精微而
制水谷聚而不散而成胀满经云腹满肿胀支膈 胁下厥上冒过在太阴阳明乃寒湿郁过也脉经所
谓胃中寒则胀满者是也(针经三卷杂病第八)腹满大便不利上走胸溢喘息喝喝然取足少阴又云
胀取三阳三阳者足太阳寒水为胀与通评虚实论说腹暴满按之不下取太阳经络胃之募也正同取者
泻也经云中满者泻之于内者是也宜以辛热散之以苦泻之淡渗利之使上下分消其湿正如开鬼门
洁净府温衣缪刺其处是先泻其血络后调其真经气血平阳布神清此治之正也或曰诸胀腹大皆属
于热者何也此乃病机总辞假令外伤风寒有余之邪自表传里寒变为热而作胃实腹满仲景以
大承气汤治之亦有膏粱之人湿热郁于内而成胀满者此热胀之谓也大抵寒胀多而热胀少治之者
宜详辨之
治疗因食用肉类、湿面及辛辣浓味食物导致的食物积滞,出现胸脘痞闷、烦乱不适的症状。
处方:枳实(麸皮炒五钱)、黄连(去须,酒洗)、大黄(用湿纸包裹煨制)、神曲(炒制)、橘皮、白术(各一两)、黄芩(二两)。
将上述药材研成极细粉末,用米汤浸透蒸饼制成丸药,大小如绿豆的一倍大。每次服用五十丸,用温开水送下。根据所伤食物的多少,临时增减剂量服用。
治疗因食用生冷坚硬食物导致的心腹部胀满、疼痛。
处方:巴豆霜(五分)、木香(二钱)、升麻、柴胡(各三钱)、草豆蔻(用面粉包裹煨熟后取仁)、香附子(炒制,各五钱)、神曲(炒至黄色)、京三棱(去皮煨制)、莪术(即石三棱,煨制,各一两)。
将上述药材研成细粉末,用米汤浸透蒸饼制成丸药,大小如绿豆的一倍大。每次服用一二十丸,用温白开水送下。根据所伤食物的多少,临时增减剂量服用。
治疗因食用豆粉、湿面及油腻食物导致的积滞。
处方:白矾(枯矾三钱)、黄芩(五钱)、橘皮(七钱)、神曲(炒至黄色)、半夏(用汤水洗七次)、白术(各一两)、枳实(麸皮炒至黄色一两一钱)。
将上述药材研成极细粉末,用米汤浸透蒸饼制成丸药,大小如绿豆大。每次服用三五十丸,用温开水送下。素食较多者多用干姜,因此加入黄芩以清泻之。
治疗在秋冬季节因受寒冷食物刺激,导致胃脘部当心而痛,并向上延伸至两胁及咽喉膈部,感觉不通畅。
处方:炒盐(五分)、干生姜、青皮、橘皮(各二钱)、麦芽面(炒至黄色)、生黄芩(冬季不用)、半夏(用汤水洗七次)、神曲(炒制,各五钱)、草豆蔻(用面粉包裹煨制后去皮取仁)、白术(各一两)、枳实(麸皮炒制二两)。
将上述药材研成极细粉末,用米汤浸透蒸饼制成丸药,大小如绿豆大。每次服用五十丸,用温开水送下。
《六元政纪论》中说:“太阴之气所致病症表现为中焦胀满;太阴之气所致病症表现为水湿蓄积而胀满;各种湿气引起的肿胀和胀满,都归属于脾土。”《内经》论述说:“脾属于阴中之太阴,同湿土之气化相应。脾湿有余则导致腹满、饮食不消化。天为阳、为热,主司运化;地为阴、为湿,主司长养万物。如果没有阳气,阴气就不能生化,所以说‘脏寒产生胀满病’。”《素问·调经篇》说:“因为饮食不节、劳倦过度损伤脾胃,起初感受热邪于中(热中),若未传变为寒邪于中(寒中),这都是由于脾胃之气虚弱,不能运化精微物质,导致水谷积聚而不散,从而形成胀满。”《内经》说:“腹部胀满、肿胀,支撑胸膈,胁下气逆上冲至头部,病位在太阴和阳明经,这是寒湿郁滞过盛所致。”《脉经》所谓“胃中有寒则胀满”即是此意(出自《针经》三卷杂病第八)。“腹满伴有大便不通利,气向上走至胸部,引起喘息,呼吸有声”,应取足少阴经穴治疗。又说:“治疗胀满应取三阳经穴。三阳经中的足太阳膀胱经属寒水,易致胀满。”这与《通评虚实论》中说的“腹部突然胀满,按压不缓解,应取太阳经络及胃的募穴”完全一致。“取”在这里意为“泻”。《内经》说“中焦胀满应从内部泻除”即是此理。适宜用辛热药物发散,用苦味药物泻下,用淡味药物渗湿利尿,使上下分消其湿。正如“开鬼门(发汗)、洁净府(利小便)”,以及“温衣缪刺其处”,这是先泻其血络,后调理其真经气血,使阴阳平衡,神气清明,这才是正确的治疗方法。有人问:“为什么说各种腹胀腹大都属于热证呢?”这是《黄帝内经·病机十九条》中的总括性论述。假如外感风寒等有余之邪,从体表传入体内,寒邪转化为热邪,导致胃腑实证、腹部胀满,张仲景用大承气汤治疗。也有那些享用膏粱厚味之人,湿热郁结于内而形成胀满的,这就是所谓的“热胀”。大体而言,寒胀多而热胀少,治疗者应当仔细辨别。
To treat food stagnation caused by consuming meat, damp noodles, and pungent or strong-flavored foods, resulting in chest and epigastric stuffiness, mental restlessness, and discomfort.
Prescription: Zhi Shi (Bitter Orange Immature Fruit, bran-fried, 5 qian), Huang Lian (Coptis Rhizome, stamens removed, wine-washed), Da Huang (Rhubarb Root and Rhizome, wrapped in wet paper and baked), Shen Qu (Medicated Leaven, fried), Ju Pi (Tangerine Peel), Bai Zhu (Atractylodes Macrocephala Rhizome, each 1 liang), Huang Qin (Scutellaria Root, 2 liang).
Grind the above herbs into an extremely fine powder. Soak steamed leavened bread dough in water to form pills, twice the size of mung beans. Take 50 pills per dose with warm water. Adjust the dosage according to the amount of ingested food.
To treat heart and abdominal fullness and pain caused by consuming raw, cold, and hard foods.
Prescription: Ba Dou Shuang (Croton Seed Frost, 5 fen), Mu Xiang (Costus Root, 2 qian), Sheng Ma (Cimicifuga Rhizome), Chai Hu (Bupleurum Root, each 3 qian), Cao Dou Kou (Black Cardamom, wrapped in flour, roasted until cooked, use the kernel), Xiang Fu (Cyperus Rhizome, fried, each 5 qian), Shen Qu (Medicated Leaven, fried until yellow), San Leng (Curcuma Zedoaria Rhizome, peeled and roasted), E Zhu (Curcuma Phaeocaulis Rhizome, roasted, each 1 liang).
Grind the above herbs into a fine powder. Soak steamed leavened bread dough in water to form pills, twice the size of mung beans. Take 10-20 pills per dose with warm plain water. Adjust the dosage according to the amount of ingested food.
To treat food stagnation caused by consuming bean powder, damp noodles, and greasy foods.
Prescription: Bai Fan (Alumen, calcined, 3 qian), Huang Qin (Scutellaria Root, 5 qian), Ju Pi (Tangerine Peel, 7 qian), Shen Qu (Medicated Leaven, fried until yellow), Ban Xia (Pinellia Tuber, washed seven times in hot water), Bai Zhu (Atractylodes Macrocephala Rhizome, each 1 liang), Zhi Shi (Bitter Orange Immature Fruit, bran-fried until yellow, 1 liang 1 qian).
Grind the above herbs into an extremely fine powder. Soak steamed leavened bread dough in water to form pills, the size of mung beans. Take 30-50 pills per dose with warm water. For those consuming more vegetarian food, dried ginger is often used; therefore, Huang Qin is added to clear and drain heat.
To treat stomach pain at the epigastrium directly below the heart, extending upwards to both hypochondria and through the throat and diaphragm causing obstruction, triggered by cold foods during autumn and winter.
Prescription: Chao Yan (Fried Salt, 5 fen), Gan Sheng Jiang (Dried Ginger), Qing Pi (Green Tangerine Peel), Ju Pi (Tangerine Peel, each 2 qian), Mai Ya Mian (Fried Barley Flour), Sheng Huang Qin (Raw Scutellaria Root, not used in winter), Ban Xia (Pinellia Tuber, washed seven times in hot water), Shen Qu (Medicated Leaven, fried, each 5 qian), Cao Dou Kou (Black Cardamom, wrapped in flour, roasted, peel removed, kernel used), Bai Zhu (Atractylodes Macrocephala Rhizome, each 1 liang), Zhi Shi (Bitter Orange Immature Fruit, bran-fried, 2 liang).
Grind the above herbs into an extremely fine powder. Soak steamed leavened bread dough in water to form pills, the size of mung beans. Take 50 pills per dose with warm water.
The *Liuyuan Zhengji Lun* states: "When Taiyin prevails, it manifests as central fullness; when Taiyin prevails, it manifests as accumulation and fullness; all swelling and fullness due to dampness belong to Spleen Earth." The *Neijing* discusses: "The Spleen is Yin within Taiyin, sharing the transformation of damp earth. Excess Spleen dampness leads to abdominal fullness and indigestion. Heaven is Yang and Heat, governing transformation and transportation; Earth is Yin and Damp, governing growth and nourishment. Without Yang, Yin cannot transform and generate; thus it is said that 'Cold in the Zang organs generates fullness diseases.'" The *Suwen: Tiao Jing Pian* states: "Due to irregular diet and overexertion damaging the Spleen and Stomach, one initially suffers from Heat in the Middle (Re Zhong); if it does not transmit to Cold in the Middle (Han Zhong), this is all because the Qi of the Spleen and Stomach is weak and unable to transform and transport essence and micro-nutrients, causing food and fluids to accumulate without dispersing, resulting in distension." The *Neijing* states: "Abdominal fullness and swelling, obstructing the chest and diaphragm, with Qi reversing from the hypochondria up to the head, the pathology lies in the Taiyin and Yangming meridians; this is due to excessive stagnation of Cold-Damp." The *Mai Jing* says, "Cold in the Stomach causes fullness," which refers to this (from *Zhen Jing*, Vol. 3, Miscellaneous Diseases Chapter 8). "Abdominal fullness with difficulty in defecation, Qi moving upward to the chest, causing panting and audible breathing" should be treated by selecting points on the Foot Shaoyin meridian. It also states: "For distension, select the Three Yang meridians. The Foot Taiyang Bladder Meridian, belonging to Cold Water, is prone to distension." This aligns perfectly with the *Tong Ping Xu Shi Lun*, which says: "Sudden abdominal fullness that cannot be relieved by pressure should be treated by selecting the Foot Taiyang meridian collaterals and the Front-Mu point of the Stomach." Here, "selecting" implies "draining." The *Neijing* states, "Central fullness should be drained from within," which is exactly this principle. It is appropriate to use Pungent-Hot herbs to disperse, Bitter herbs to purge, and Acrid/Insipid herbs to promote diuresis, thereby dispersing dampness from above and below. This is just like "opening the ghost gate (sweating) and cleansing the residence (diuresis)," and "warming the clothes and applying Mi Ci needling," which first drains the blood collaterals and then regulates the Qi and Blood of the True Meridians, achieving balance of Yin and Yang, clarity of Spirit, and this is the correct treatment method. One might ask: "Why does it say that all distensions and abdominal enlargements belong to Heat?" This is a general statement from the *Bing Ji* (Pathogenesis). For example, if external pathogenic factors such as Wind-Cold, being excess pathogens, transmit from the exterior to the interior, transforming from Cold to Heat, leading to Stomach excess and abdominal fullness, Zhang Zhongjing treats this with Da Cheng Qi Tang. There are also those who consume rich and fatty foods, where Damp-Heat stagnates internally causing distension; this is referred to as "Heat Distension." Generally speaking, Cold Distension is more common than Heat Distension, so practitioners must distinguish carefully.