治饮食不时,饥饱劳役,胃气不足,脾气下溜,气短无力,不能寒热,早饭后转增昏闷,须要眠
睡,怠惰,四肢不收,懒倦动作,及五心烦热。
浓朴(姜制,五分) 升麻 羌活 白芍药,独活 防风 甘草(炙) 泽泻(以上各一钱)
生地黄(一钱五分) 柴胡(二钱五分)
上件为粗末,每服五钱,水二盏,生姜三片,枣二枚,煎至一盏,去渣,大温服,食前。
如腹胀及窄狭,加浓朴。
如腹中似硬,加砂仁三分。
《刺志论》云∶“气虚身热,得之伤暑”。热伤气故也。《痿论》云∶“有所远行劳倦,逢大热而渴,
渴则阳气内伐,内伐则热舍于肾,肾者水脏也,今水不能胜火,则骨枯而髓虚,故足不任身,发为骨痿。
故《下经》曰∶骨痿者,生于大热也。”此湿热成痿,令人骨乏无力,故治痿独取阳明。
时当长夏,湿热大胜,蒸蒸而炽。人感之多四肢困倦,精神短少,懒于动作,胸满气促,肢节沉痛;
或气高而喘,身热而烦,心下膨痞,小便黄而少,大便溏而频,或痢出黄糜,或如泔色;或渴或不渴,
不思饮食,自汗体重;或汗少者,血先病而气不病也。其脉中得洪缓,若湿气相搏,必加之以迟,迟
病虽互换少差,其天暑湿令则一也。宜以清燥之剂治之,名之曰清暑益气汤主之。
治疗因饮食不规律、饥饱不均以及劳累过度导致的胃气不足,脾气下陷,出现气短无力,无法适应寒热变化,早饭后症状加重并感到昏闷,必须睡觉,精神倦怠,四肢松软无力,懒于活动,以及五心烦热。
处方:浓朴(姜制,五分)、升麻、羌活、白芍药、独活、防风、甘草(炙)、泽泻(以上各一钱)、生地黄(一钱五分)、柴胡(二钱五分)。
将上述药材捣成粗末,每次服用五钱,加水两盏,生姜三片,大枣二枚,煎煮至一盏,去渣,趁大温热服,饭前服用。
如果腹中感觉似硬,加用砂仁三分。
《刺志论》说:“气虚而身体发热,这是由伤暑引起的。”这是因为热邪耗伤元气所致。《痿论》说:“如果有远行劳倦,遇到大热而口渴,口渴则阳气在内攻伐,内攻伐则热邪留舍于肾。肾是水脏,如今水不能胜火,则骨骼枯槁而髓液空虚,所以双脚不能支撑身体,发为骨痿。因此《下经》说:‘骨痿,是由于大热引起的。’”这是湿热导致痿证,使人骨骼乏力无力,所以治疗痿证唯独取法阳明经。
当时正值长夏季节,湿热之气极盛,热气蒸腾炽烈。人感受此邪多表现为四肢困倦,精神短少,懒于动作,胸中满闷气促,肢节沉重疼痛;或者气逆而喘,身热而烦,心下膨满痞塞,小便黄而量少,大便溏薄而次数频繁,或者痢疾排出黄色糜烂物,或者像米泔水的颜色;或者口渴或者不渴,不想饮食,自汗体重;或者汗少的,是血先病而气未病。其脉象中得洪缓之象,若湿气相搏,必然加上迟脉。迟脉的病虽然与其他脉象稍有差异,但天暑湿令的气候条件是一致的。适宜用清燥的方剂治疗,名为清暑益气汤来主治。
Treatment for insufficient Stomach Qi (Stomach Qi) due to irregular diet, alternating hunger and fullness, and physical overexertion; sinking of Spleen Qi (Spleen Qi); shortness of breath and weakness; inability to adapt to cold and heat; worsening dizziness and stuffiness after breakfast, requiring sleep; lethargy; flaccidity and lack of strength in the four limbs; reluctance to move; and five-palm heat (heat sensation in the palms, soles, and chest).
Shengyang Buzhi Tang (Ascending Yang and Tonifying Qi Decoction):
Cortex Magnoli Officinalis Preparata (Nongpu, processed with ginger, 5 fen), Rhizoma Cimicifugae (Shengma), Radix Notopterygii (Qianghuo), Radix Paeoniae Alba (Baishao), Radix Angelicae Pubescentis (Duhuo), Ramulus Saposhnikoviae (Fangfeng), Radix Glycyrrhizae Preparata (Gancao, honey-fried), Rhizoma Alismatis (Zexie) [each 1 qian];
Radix Rehmanniae Preparata (Shengdihuang, 1.5 qian);
Radix Bupleuri (Chaihu, 2.5 qian).
Pulverize the above ingredients into a coarse powder. Take 5 qian per dose, add two zhan of water, three slices of fresh ginger, and two jujubes. Decoct until one zhan remains, strain, and take warm before meals.
If abdominal distension and tightness occur, add Cortex Magnoli Officinalis Preparata.
If the abdomen feels hard, add Pericarpium Amomi Rotundus (Sharen, 3 fen).
The *Suwen: Cizhi Lun* states: "Qi deficiency with body heat results from summerheat injury." This is because heat damages Qi. The *Suwen: Weilun* states: "When one travels far and becomes fatigued, encountering intense heat and thirst, thirst causes Yang Qi to attack internally. Internal attack allows heat to lodge in the Kidney. The Kidney is the Water organ; now Water cannot overcome Fire, leading to dry bones and empty marrow. Thus, the feet cannot support the body, resulting in bone Wei syndrome (flaccidity syndrome). Therefore, the *Xiajing* says: 'Bone Wei syndrome arises from great heat.'" This refers to damp-heat causing Wei syndrome, leading to skeletal fatigue and weakness; hence, treatment of Wei syndrome focuses exclusively on the Yangming channel.
During late summer, damp-heat prevails overwhelmingly, steaming and blazing. Contracting this pathogen often manifests as fatigue in the four limbs, diminished spirit and energy, reluctance to move, chest fullness and shortness of breath, heaviness and pain in the joints; or upward rushing Qi with panting, body heat with vexation, epigastric distension and痞 (stuffiness), yellow and scant urine, loose and frequent stools, or dysentery discharging yellow mushy matter or rice-water-like fluid; thirst or no thirst, anorexia, spontaneous sweating with heavy body; or scant sweating, indicating blood disease preceding Qi disease. The pulse presents as surging and moderate (Hong-Huan); if dampness combats it, a slow (Chi) pulse may be added. Although diseases indicated by different pulses vary slightly, the climatic condition of summer heat and dampness remains the same. It is appropriate to treat with a formula that clears dryness and heat, named Qingshu Yiqi Tang (Clear Summerheat and Boost Qi Decoction).