《千金方》治粥食汤药皆吐不停者,灸手间使穴三十壮。穴属手厥阴,在掌后三寸。今
人罕知
用此法者,治吐汤药,虞天民方最善,用顺流水二盏,煎沸,汤泡伏龙肝研细搅浑,放澄清
取一盏,入参、苓、白术各一钱,甘草二分,陈皮、藿香、砂仁各五分,炒神曲一钱,陈米
一合,加姜枣同煎至七分,稍冷服,别以陈米煎汤时时咽之,此法治胃虚不能纳食者皆效。
又黄退庵治胃阴受戕,纳食即吐者,用人乳同糯米饮缓缓服之,亦应验如神。
头痛属太阳者,自脑后上至巅顶,其痛连项;属阳明者,上连目珠,痛在额前;属少阳
者,
上至两角,痛在头角。以太阳经行身之后,阳明经行身之前,少阳经行身之侧。厥阴之脉会
于巅顶,故头痛在巅顶。太阴、少阴二经虽不上头,然痰与气逆壅于膈,头上气不得畅而亦
痛。其辨之之法,六经各有见症,如太阳项强腰脊痛,阳明胃家实,少阳口苦、咽干、目眩
之类是也。高士宗《医学真传》言头痛之症,只及太阳、少阴、厥阴,疏矣。
胁痛当辨左右,有谓左为肝火或气,右为脾火或痰与食。(丹溪则谓左属瘀血右属痰。)
有谓
左属肝,右为肝移邪于肺。余观程杏轩治胁痛在右而便闭,仿黄古潭治左胁痛法,用栝蒌一
枚,甘草二钱,红花五分神效,以栝蒌滑而润下,能治插胁之痛,甘草缓中濡燥,红花流通
血脉,肝柔肺润,其效可必,是肝移邪于肺之说为的也。又观薛立斋治右胁胀痛,喜手按者
,谓是肝木克脾土,而脾土不能生肺金,则为脾为肺,固一以贯之矣。
《千金方》记载,对于服用粥、饭、汤剂或药物后呕吐不止的情况,可灸手厥阴心包经的间使穴三十壮。该穴位属于手厥阴经,位于手腕横纹上三寸处。如今很少有人知道使用这种方法。治疗呕吐时,虞天民的方子最为有效:取顺流水两盏,煮沸,将研细的伏龙肝(灶心土)粉末加入沸水中搅匀,静置澄清后取上层清液一盏,加入人参、茯苓、白术各一钱,甘草二分,陈皮、藿香、砂仁各五分,炒神曲一钱,陈米一合,再加入生姜和大枣一同煎煮至七分量,待药液稍凉后服用;另外用陈米煎汤,不时少量咽下。此法对胃气虚弱不能受纳食物者均有效。
此外,黄退庵治疗因胃阴受损导致进食即吐的患者,让人乳与糯米一起慢慢饮用,也效果神奇。
头痛若归属于太阳经,疼痛从脑后向上延伸至头顶,并牵连颈部;若归属于阳明经,疼痛向上连接眼球,部位在前额;若归属于少阳经,疼痛向上延伸至头两侧,部位在头角。这是因为太阳经行于身体后方,阳明经行于身体前方,少阳经行于身体侧面。厥阴经的脉气会聚于头顶,所以头痛在头顶部位。太阴经和少阴经虽然不直接上行至头部,但如果痰湿与气逆壅塞于胸膈,导致头部气机不畅,也会引起头痛。辨别这些情况的方法是观察六经各自的表现症状,例如太阳经表现为项强、腰脊痛,阳明经表现为胃家实(胃肠实热),少阳经表现为口苦、咽干、目眩等。高士宗在《医学真传》中论述头痛病症,只涉及太阳、少阴、厥阴三经,这是疏漏的。
胁痛应当辨别左右,有人说左侧属肝火或肝气郁结,右侧属脾火或痰湿与食积。(朱丹溪则认为左侧属瘀血,右侧属痰湿。)也有人说左侧属肝,右侧是肝将病邪转移给肺。我观察到程杏轩治疗右侧胁痛且伴有大便闭塞的患者,仿照黄古潭治疗左侧胁痛的方法,使用栝蒌一枚,甘草二钱,红花五分,效果显著。因为栝蒌滑润下行,能治疗插入胁肋部的疼痛,甘草缓和其中焦燥急,红花流通血脉,使肝气柔和、肺气滋润,疗效必然出现,这证明了“肝移邪于肺”的说法是正确的。我又观察到薛立斋治疗右侧胁部胀痛、喜欢用手按压的患者,认为是肝木克制脾土,而脾土不能生养肺金,从而涉及脾和肺,这一观点是一以贯之的。
The *Qianjin Fang* (Prescriptions Worth a Thousand Gold) records that for cases where vomiting persists despite taking porridge, rice, soups, or medicines, moxibustion can be applied to the Jianshi (PC5) acupoint on the hand for thirty moxa cones. This acupoint belongs to the Hand-Jueyin Pericardium Meridian and is located three cun above the wrist crease. Nowadays, few people know to use this method. For treating vomiting, the prescription by Yu Tianmin is the most effective: take two cups of smooth-flowing water, boil it, add finely ground Fulonggan (Caulis Longan / Hearth Soil), stir well, let it settle, and take one cup of the clarified liquid. Add Renshen (Ginseng Radix et Rhizoma), Lingzhi (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma) each one qian, Gancao (Licorice Root) two fen, Chenpi (Citri Reticulatae Pericarpium), Huoxiang (Agastaches Herba), Sharen (Amomi Fructus) each five fen, Chao Shenqu (Fried Massa Medicata Fermentata) one qian, and Chenmi (Old Rice) one he. Add Jiang (Zingiberis Rhizoma) and Zao (Jujubae Fructus), decoct until reduced to seventy percent volume, and take when slightly cool. Additionally, decoct old rice in water and swallow small amounts frequently. This method is effective for those with Spleen-Stomach deficiency unable to receive food.
Furthermore, Huang Tui'an treated patients whose Stomach Yin was damaged, causing immediate vomiting after eating, by having them slowly drink human milk mixed with glutinous rice, which also proved miraculously effective.
Headache attributed to the Taiyang (Greater Yang) meridian extends from the back of the head up to the vertex, radiating to the neck; headache attributed to the Yangming (Yang Brightness) meridian connects upward to the eyeballs, with pain in the forehead; headache attributed to the Shaoyang (Lesser Yang) meridian extends to the temples, with pain at the sides of the head. This is because the Taiyang meridian runs along the posterior aspect of the body, the Yangming meridian along the anterior aspect, and the Shaoyang meridian along the lateral aspect. The Jueyin (Terminal Yin) meridian converges at the vertex, hence headache occurs at the top of the head. Although the Taiyin (Greater Yin) and Shaoyin (Lesser Yin) meridians do not ascend directly to the head, if Phlegm and rebellious Qi obstruct the diaphragm, preventing smooth Qi flow in the head, headache may also result. The method to differentiate these involves observing the specific symptoms of the Six Meridians: for example, Taiyang presents with stiffness of the neck and lower back pain; Yangming presents with excess heat in the Stomach and Intestines (Wei Jia Shi); Shaoyang presents with bitter taste in the mouth, dry throat, and vertigo/dizziness. Gao Shizong, in *Yixue Zhuan Chuan* (True Transmission of Medicine), discussed headache only in relation to the Taiyang, Shaoyin, and Jueyin meridians, which is an oversight.
Hypochondriac pain should be differentiated by left and right sides. Some say the left side relates to Liver Fire or Liver Qi stagnation, while the right side relates to Spleen Fire, Phlegm, or Food Retention. (Zhu Danxi stated that the left side relates to Blood Stasis and the right side to Phlegm.) Others say the left side belongs to the Liver, and the right side indicates the Liver transferring pathogenic factors to the Lung. I observed Cheng Xingxuan treating hypochondriac pain on the right side accompanied by constipation. He imitated Huang Gutan's method for left-sided hypochondriac pain, using one Gualou (Trichosanthis Fructus), two qian of Gancao (Licorice Root), and five fen of Honghua (Carthami Flos), achieving miraculous effects. This is because Gualou is slippery and moistening, promoting downward movement, capable of treating piercing pain in the hypochondrium; Gancao moderates the middle and moistens dryness; Honghua invigorates blood circulation. With the Liver becoming soft and the Lung moist, the efficacy is certain, confirming that the theory of "Liver transferring pathogen to the Lung" is accurate. I also observed Xue Lizhai treating distending and painful hypochondriac pain on the right side, which the patient preferred to press with hands, stating it was due to Liver Wood overacting on Spleen Earth, and since Spleen Earth could not generate Lung Metal, it involved both Spleen and Lung, maintaining a consistent theoretical framework.