治伤热食痞闷兀兀欲吐烦乱不安
甘草(二钱) 升麻 柴胡(各三钱) 黄连(酒洗一两) 黄芩(二两)
一方加枳实(五钱)
上为细末汤浸 饼为丸如绿豆大每服五十丸白汤下食远
治伤冷冻饮料者以五苓散每服二钱三钱匕加生姜煎服之
治伤食兼伤冷冻饮料者煎五苓散送半夏枳术丸
治伤冷冻饮料不恶寒者腹中亦不觉寒惟觉闷身重食不化者或小便不利煎去桂五苓散根据前斟酌
服之
上部有脉下部无脉其人当吐不吐者死何谓下部无脉此谓木郁也饮食过饱填塞胸中胸中者
太阴之分野经曰气口反大于人迎三倍食伤太阴故曰木郁则达之吐者是也
瓜蒂 赤小豆(各等分)
上二味为极细末每服二钱匕温浆水调下取吐为度若不至两手尺脉绝无不宜便用此药恐损
元气
令人胃气不复若止是胸中窒塞闷乱不通以指探去之如不得吐者以物探去之得吐则已如食不去
用
此药吐之解云盛食填塞于胸中为之窒塞两寸脉当主事两尺脉不见其理安在胸中有食故以吐出
之食者物也物者坤土也是足太阴之号也胸中者肺也为物所填肺者手太阴金也金主杀伐也与坤
土俱在于上而旺于天金能克木故肝木生发之气伏于地下非木郁而何吐去上焦阴土之物木得舒
畅则郁结去矣食塞于上脉绝于下若不明天地之道无由达此至理水火者阴阳之征兆天地之别名
也故曰独阳不生独阴不长天之用在于地下则万物生长矣地之用在于天上则万物收藏矣此乃天
地交而万物通也此天地相根之道也故阳火之根本于地下阴水之源本于天上故曰水出高源故人
五脏主有形之物物者阴也阴者水也右三部脉主之偏见于寸口食塞其二是绝五脏之源源绝则水
不下流两尺竭绝此其理也何疑之有假令所伤前后不同以分为率伤热物二分伤生冷硬物一分用
寒药三黄丸二停热药巴豆三棱丸一停合而服之如热物伤少而寒物伤多则寒药少而热药多也假
令夏月大热之时伤生冷硬物当用热药巴豆三棱丸治之须加三黄丸谓天时不可伐故加寒药以顺
时令若热物只用三黄丸何谓此三黄丸时药也假令冬天大寒之时伤羊肉湿面等热物当用三黄丸
治之须加热药少许草豆蔻丸之类是也为引用又为时药经云必先岁气无伐天和此之谓也余皆仿
此
治疗因热食积滞导致的痞满、恶心欲吐、心烦意乱、坐卧不安:
甘草(二钱),升麻,柴胡(各三钱),黄连(酒洗一两),黄芩(二两)。
另一配方加入枳实(五钱)。
以上药物研成细末,用汤剂浸泡后,与面饼混合制成如绿豆大小的丸药。每次服用五十丸,饭后用白开水送服。
治疗因饮用冷冻饮料所致损伤者,使用五苓散,每次服用二钱或三钱匕,加生姜煎煮后服用。
治疗既伤食又伤冷冻饮料者,煎煮五苓散,用它来送服半夏枳术丸。
治疗因冷冻饮料损伤且无恶寒症状,腹部也不觉寒冷,只感觉身体困重、胸闷、食物不消化,或者小便不通利者,煎煮去掉桂枝的五苓散,根据前述情况斟酌剂量服用。
上部有脉搏而下部无脉搏的人,应当呕吐却吐不出来,这是死证。什么叫下部无脉搏?这叫做木郁(肝气郁结)。饮食过饱,填塞胸中。胸中是太阴经所主的区域。医经说:“气口脉比人迎脉大三倍”,这是饮食损伤太阴经的缘故,所以说“木郁则达之”,催吐就是这种方法。
瓜蒂,赤小豆(各等分)。
以上两味药研成极细的粉末,每次服用二钱匕,用温浆水调服,以引起呕吐为度。如果两手尺部脉搏完全摸不到,就不宜立即使用此药,恐怕会损伤元气,导致胃气无法恢复。如果只是胸中窒塞、闷乱不通,可以用手指探入咽喉催吐;如果不行,就用物体探喉催吐。如果能吐出就好了。如果食物未去除,再用此药催吐。
解说:盛食填塞于胸中,造成窒塞感,此时两寸脉应当明显,而两尺脉看不见,其中的道理何在?因为胸中有食物,所以通过催吐排出。食物属于物,物属于坤土,这是足太阴脾的代号。胸中属于肺,肺属手太阴金。金主杀伐,与坤土都位于上部,且旺盛于天。金能克木,所以肝木生发之气潜伏于地下,这难道不是木郁吗?将上焦阴土性质的食物吐出,木气得以舒畅,郁结就去除了。食物堵塞在上部,脉搏在下部断绝,如果不明白天地之道,就无法通达这一至理。
水和火是阴阳的象征,也是天地的别称。所以说“独阳不生,独阴不长”。天的作用在于地下,万物才能生长;地的作用在于天上,万物才能收藏。这就是天地交泰而万物通畅的道理,也就是天地相互根本的关系。所以阳火的根本在地下,阴水的源头在天上,因此说“水出高源”。人的五脏主管有形之物,物属于阴,阴属于水,由右三部脉(寸、关、尺)主导。偏见于寸口,是因为食物堵塞了其中两个部位,断绝了五脏的源头。源头断绝,水就不能下流,导致两尺脉枯竭断绝,其中的道理有什么可怀疑的呢?
假如所伤的食物前后不同,按比例分配:伤热性食物占二分,伤生冷硬物占一分。使用寒性药三黄丸两份,热性药巴豆三棱丸一份,混合服用。如果热性食物伤得少而寒性食物伤得多,那么寒药就少,热药就多。
假如在夏季大热之时,伤了生冷硬物,应当使用热性药巴豆三棱丸治疗,但必须加入三黄丸,这是因为天时炎热不可违背,所以要加寒药以顺应时令。如果仅是热性食物损伤,只用三黄丸即可。为什么说三黄丸是时药呢?假如在冬季大寒之时,伤了羊肉、湿面等热性食物,应当使用三黄丸治疗,但必须加入少许热性药如草豆蔻丸之类作为引经药和时药。医经说:“必须先了解当年的气候特点,不要违背天和自然规律”,说的就是这个道理。其余情况都仿照这个原则处理。
Treatment for discomfort, fullness, nausea with urge to vomit, restlessness, and anxiety caused by heat-inducing food stagnation:
Gancao (Radix Glycyrrhizae Preparata), Shengma (Rhizoma Cimicifugae), Chaihu (Radix Bupleuri) (each 3 qian), Huanglian (Rhizoma Coptidis, washed in wine, 1 liang), Huangqin (Radix Scutellariae, 2 liang).
Another prescription adds Zhishi (Fructus Aurantii Immaturus, 5 qian).
Grind the above ingredients into a fine powder. Soak in decoction, mix with dough, and form pills the size of mung beans. Take 50 pills per dose, swallowed with warm water after meals.
For injuries caused by consuming frozen beverages, use Wuling San (Five-Ingredient Poria Pill). Take 2 or 3 qian/bi per dose, decocted with fresh ginger slices.
For cases involving both food injury and injury from frozen beverages, decoct Wuling San and use it to deliver Banxia Zhizhu Wan (Pinellia and Atractylodes Macrocephala Pill).
For injuries from frozen beverages without aversion to cold, where the abdomen does not feel cold but there is only a sensation of heaviness, chest stuffiness, indigestion, or difficulty in urination, decoct Wuling San with Gui Zhi (Ramulus Cinnamomi Cassiae) removed, and adjust the dosage according to the aforementioned principles.
When the pulse is present in the upper part (cun position) but absent in the lower part (chi position), the patient should vomit; if unable to vomit, it indicates a fatal condition. What is meant by "absent pulse in the lower part"? This refers to Wood Stagnation (Liver Qi Stagnation). Overeating fills the chest. The chest is the domain governed by the Taiyin (Spleen/Lung) channels. The medical classics state: "The Qikou (radial artery at the wrist) pulse is three times larger than the Renying (carotid artery) pulse," indicating that food damage affects the Taiyin channel. Therefore, it is said: "When Wood is stagnant, it must be dispersed." Vomiting is the method to achieve this.
Gudie (Fructus Momordicae), Chi Xiaodou (Semens Phaseoli Angularis) (equal parts).
Grind these two ingredients into an extremely fine powder. Take 2 qian/bi per dose, mixed with warm Jiangshui (fermented rice water). Induce vomiting as the goal. If the chi pulses are completely imperceptible in both hands, do not use this medicine immediately, as it may damage Yuanqi (Primal Qi) and prevent the recovery of Weiqi (Stomach Qi). If there is merely chest stuffiness, oppression, and blockage, one may induce vomiting by stimulating the throat with a finger; if ineffective, use an object to stimulate the throat. Vomiting resolves the issue. If the food remains, use this medicine again to induce vomiting.
Explanation: When excessive food fills the chest, causing obstruction, the cun pulses should be prominent while the chi pulses are absent. Why? Because food resides in the chest. Food belongs to Wu (things), which corresponds to Kun Earth, representing the Foot Taiyin Spleen. The chest belongs to the Lung, Hand Taiyin Metal. Metal governs killing and cutting. Both Kun Earth and Metal reside in the upper jiao and are prosperous in the Heaven aspect. Metal overcomes Wood, so the ascending energy of Liver Wood is suppressed underground. Is this not Wood Stagnation? By vomiting out the Yin-Earth substances from the Upper Jiao, Wood Qi can expand freely, resolving the stagnation. When food blocks the upper body, the pulse disappears below. Without understanding the Way of Heaven and Earth, one cannot comprehend this profound principle.
Water and Fire are manifestations of Yin and Yang, and alternate names for Earth and Heaven. Thus, it is said: "Solitary Yang does not generate; solitary Yin does not grow." The function of Heaven lies beneath the Earth, allowing all things to grow; the function of Earth lies above in Heaven, allowing all things to be stored. This is the communication between Heaven and Earth through which all things flow smoothly—the way Heaven and Earth root each other. Therefore, the root of Yang Fire is in the Earth, and the source of Yin Water is in Heaven. Hence, it is said: "Water flows from high sources." The five Zang organs govern有形 (material) things. Things belong to Yin, and Yin belongs to Water. These are controlled by the three positions on the right hand (cun, guan, chi). When the pulse manifests predominantly at the cun position, it is because food has blocked two of the three positions, severing the source of the five Zang organs. When the source is severed, Water cannot flow downward, leading to the exhaustion and absence of the chi pulses. What is there to doubt in this logic?
If the injured foods differ in nature, calculate the ratio: assume heat-inducing food accounts for two parts, and cold/raw/hard food accounts for one part. Use Sanhuang Wan (Three-Yellow Pill, a cold-natured formula) in two portions and Badou Sanleng Wan (Croton and Curcuma Pill, a hot-natured formula) in one portion, mixed and taken together. If heat-inducing food causes less injury and cold-inducing food causes more, then use less cold medicine and more hot medicine.
For example, during the intense heat of summer, if one injures themselves with cold/raw/hard food, one should use the hot medicine Badou Sanleng Wan. However, one must add Sanhuang Wan because the seasonal climate is hot and should not be violated; thus, cold medicine is added to harmonize with the season. If only heat-inducing food is injured, Sanhuang Wan alone suffices. Why is Sanhuang Wan considered a "seasonal medicine"? For instance, during the severe cold of winter, if one injures themselves with heat-inducing foods like lamb or wet noodles, one should use Sanhuang Wan but must add a small amount of hot medicine, such as Caodoukou Wan (Cardamom Pill), as a guiding agent and seasonal adjustment. The classics state: "One must first understand the annual qi (climate) and not violate the Harmony of Heaven." This is what is meant. All other cases follow this pattern.