吞酸者,多属于肝。缘肝盛侮脾,久之脾土虚弱,传运较迟,饮食停滞, 杂不堪,此酸味所由作
也。如脾虚不运有寒者,以二陈汤加吴茱萸、生姜主之。如脾虚不运有寒有热者,以连理汤加陈皮、半夏
主之。如饮食不化属实者,以平胃散主之。如饮食不化属虚者,以六君子汤主之。
二陈汤
(方见眩晕) 加吴茱萸、生姜,水煎大半杯,温服。
连理汤
人参 白术 干姜 甘草(炙) 黄连(各一钱) 加陈皮、半夏水煎大半杯,温服。
平胃散
苍术(三钱炒) 陈皮(二钱) 浓朴(二钱炒) 甘草(一钱炙) 加生姜五片,水煎
大半杯,温服。
六君子汤
(方见疟疾)
泄泻者,肝脾之下陷也。常人谷贮于大肠,水渗于膀胱,一自土湿而脾无蒸化之力,木郁而肝失疏
泄之权,则水气不入于膀胱,而与谷合趋于大肠,此泄泻所由作也。其土湿盘结于胸腹,则生胀满。其
木郁冲激于脏腑,则生疼痛,其势使之然也。如泄泻初起,腹痛胀满,小水不利,病属寒湿者,以胃苓汤
加减主之。如脾阳已败,肠胃寒滑者,以茯苓四逆汤主之。如下利清谷,里寒外热,汗出而厥者,以通
脉四逆汤主之。如五
更至天明,腹痛而泻,有定候,属脾肾虚寒者,以四神丸主之。如久泻寒热并作者,以乌梅丸主之。
胃苓汤
(方见气鼓) 加生姜三斤,水煎大半杯,温服。如寒甚下利清谷,或加干姜、附子。
或加吴茱萸。如热甚下利肠垢,去桂枝,加黄芩。如虚甚,加人参。
茯苓四逆汤
人参(二钱) 甘草(二钱) 茯苓(三钱) 干姜(三钱) 附子(三钱) 水煎大半
杯,温服。呕加半夏。
通脉四逆汤
干姜(五钱) 附子(三钱) 甘草(三钱炙) 水煎大半杯,温服。
加味理中汤
人参(三钱) 白术(三钱) 干姜(二钱) 甘草(二钱) 茯苓(三钱) 山药(三钱)
扁豆(三钱) 脾虚作泻者,宜用此方。
四神丸
补骨脂(四两酒炒) 肉豆蔻(面煨去油) 五味子(各二两) 吴茱萸(一两汤泡)
以大枣八十一枚,生姜四两,同煮烂,去皮核,和为丸,如梧子大,临睡以米汤送下四钱。去肉豆蔻,
加人参、茯苓、干姜、附子、罂粟壳,以米汤泛丸,更效。
乌梅丸
乌梅(九十三枚) 细辛(六钱) 干姜(一两) 黄连(一两六钱) 蜀椒(四钱炒) 当归(四
钱) 桂枝(六钱) 附子(六钱) 人参(六钱) 黄柏(六钱) 各研末,以苦酒浸乌梅一宿,去核,饭上蒸之
,捣成泥,和药令相得,入炼蜜,共捣千下,丸如桐子大。先饮食,白饮和服十丸,日三服,渐加至二十丸。
吞酸这一症状,大多归属于肝脏。因为肝气过盛会克制脾土,久而久之导致脾土虚弱,传导和运化功能变慢,饮食停滞在体内,混杂不堪,这就是酸味产生的原因。如果是脾虚不能运化且伴有寒邪的,用二陈汤加上吴茱萸、生姜来主治。如果是脾虚不能运化且寒热错杂的,用连理汤加上陈皮、半夏来主治。如果是饮食不消化且属于实证(邪气盛)的,用平胃散来主治。如果是饮食不消化且属于虚证(正气虚)的,用六君子汤来主治。
二陈汤
(方剂见眩晕章节) 加吴茱萸、生姜,用水煎煮取大半杯药汁,温服。
连理汤
人参、白术、干姜、甘草(炙)、黄连(各一钱),加陈皮、半夏,用水煎煮取大半杯药汁,温服。
平胃散
苍术(三钱,炒)、陈皮(二钱)、浓朴(二钱,炒)、甘草(一钱,炙),加生姜五片,用水煎煮取大半杯药汁,温服。
泄泻,是肝气和脾气下陷所致。普通人食物储存在大肠,水液渗入膀胱,一旦土湿困阻而脾失去蒸腾气化的能力,木郁结而肝失去疏泄的功能,那么水气就不能进入膀胱,而是与谷物混合趋向于大肠,这就是泄泻产生的原因。如果土湿盘结在胸腹部,就会产生胀满感。如果木郁结冲激脏腑,就会产生疼痛,这是病势自然发展的结果。如果泄泻初起,腹痛胀满,小便不利,病属寒湿的,用胃苓汤加减来主治。如果脾阳已经衰败,肠胃寒冷滑脱的,用茯苓四逆汤来主治。如果出现下利清谷(拉出未消化的食物),里寒外热,出汗且四肢厥冷的,用通脉四逆汤来主治。如果从五更天到黎明时分,腹痛而泻,有固定的时间规律,属脾肾虚寒的,用四神丸来主治。如果久泻且寒热并作的,用乌梅丸来主治。
胃苓汤
(方剂见气鼓章节) 加生姜三斤,用水煎煮取大半杯药汁,温服。如果寒邪严重导致下利清谷,可加干姜、附子,或加吴茱萸。如果热邪严重导致下利肠垢(排泄物中有粘液脓血),去掉桂枝,加黄芩。如果虚损严重,加人参。
茯苓四逆汤
人参(二钱)、甘草(二钱)、茯苓(三钱)、干姜(三钱)、附子(三钱),用水煎煮取大半杯药汁,温服。呕吐者加半夏。
通脉四逆汤
干姜(五钱)、附子(三钱)、甘草(三钱,炙),用水煎煮取大半杯药汁,温服。
加味理中汤
人参(三钱)、白术(三钱)、干姜(二钱)、甘草(二钱)、茯苓(三钱)、山药(三钱)、扁豆(三钱)。脾虚导致的泄泻,适宜使用此方。
四神丸
补骨脂(四两,酒炒)、肉豆蔻(面煨去油)、五味子(各二两)、吴茱萸(一两,汤泡)。用大枣八十一枚,生姜四两,同煮至烂熟,去皮核,调和制成丸药,如梧桐子大小,临睡前用米汤送服四钱。去掉肉豆蔻,加入人参、茯苓、干姜、附子、罂粟壳,用米汤泛丸,效果更好。
乌梅丸
乌梅(九十三枚)、细辛(六钱)、干姜(一两)、黄连(一两六钱)、蜀椒(四钱,炒)、当归(四钱)、桂枝(六钱)、附子(六钱)、人参(六钱)、黄柏(六钱)。各研成末,用醋浸泡乌梅一夜,去核,放在饭上蒸熟,捣成泥状,与药粉混合均匀,加入炼蜜,共同捣一千下,制成如梧桐子大小的丸药。先吃饭,后用白饮(米汤或温水)送服十丸,每日三次,逐渐增加至二十丸。
Acid regurgitation (Tun Suan) is mostly attributed to the Liver. This is because excessive Liver Qi overacts upon Spleen Earth; over time, Spleen Earth becomes deficient, leading to slower transmission and transformation. Food stagnates in the body, mixing turbidly, which gives rise to the sour taste. For cases of Spleen deficiency with failure of transportation accompanied by Cold, Er Chen Tang (Two-Aged Decoction) added with Evodiae Fructus (Wuzhuyu) and Zingiberis Rhizoma Recens (Shengjiang) should be used. For cases of Spleen deficiency with failure of transportation accompanied by both Cold and Heat, Lian Li Tang (Coptis and Ginseng Combined Decoction) added with Citri Reticulatae Pericarpium (Chenpi) and Pinelliae Rhizoma (Banxia) should be used. For cases of undigested food belonging to Excess (Shi), Ping Wei San (Peaceful Stomach Powder) should be used. For cases of undigested food belonging to Deficiency (Xu), Liu Jun Zi Tang (Six-Gentlemen Decoction) should be used.
Er Chen Tang
(See formula under Vertigo) Add Evodiae Fructus (Wuzhuyu) and Zingiberis Rhizoma Recens (Shengjiang). Decoct in water to obtain half a cup, take warm.
Lian Li Tang
Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Gan Jiang (Zingiberis Rhizoma), Gan Cao (Licorice Root and Rhizoma, honey-fried), Huang Lian (Coptidis Rhizoma) (each 1 qian). Add Citri Reticulatae Pericarpium (Chenpi) and Pinelliae Rhizoma (Banxia). Decoct in water to obtain half a cup, take warm.
Ping Wei San
Cang Zhu (Atractylodis Rhizoma, 3 qian, stir-fried), Chen Pi (Citri Reticulatae Pericarpium, 2 qian), Hou Po (Magnoliae Officinalis Cortex, 2 qian, stir-fried), Gan Cao (Licorice Root and Rhizoma, 1 qian, honey-fried). Add five slices of Sheng Jiang (Zingiberis Rhizoma Recens). Decoct in water to obtain half a cup, take warm.
Liu Jun Zi Tang
(See formula under Malaria)
Diarrhea (Xie Xie) results from the sinking of Liver and Spleen Qi. Normally, grain is stored in the Large Intestine, and fluids seep into the Bladder. Once dampness obstructs Earth and the Spleen loses its power of steaming and transforming, and Wood stagnates causing the Liver to lose its authority of free flow and drainage, fluid qi cannot enter the Bladder but instead mixes with grain and trends toward the Large Intestine. This is how diarrhea arises. If dampness knots in the chest and abdomen, distension and fullness occur. If stagnant Wood attacks the Zang-Fu organs, pain occurs; this is the natural progression of the pathogenic process. For early-stage diarrhea with abdominal pain, distension, and difficult urination, where the disease belongs to Cold-Dampness, Wei Ling Tang (Stomach and Wu Ling Powder) modified should be used. If Spleen Yang has failed and the intestines and stomach are cold and slippery, Fu Ling Si Ni Tang (Poria Four-Reversal Decoction) should be used. For cases of purging undigested food, interior Cold with exterior Heat, sweating, and cold extremities, Tong Mai Si Ni Tang (Unblocking Pulse Four-Reversal Decoction) should be used. For diarrhea occurring from the fifth watch until dawn, with abdominal pain and fixed timing, belonging to Spleen-Kidney Deficiency-Cold, Si Shen Wan (Four Spirits Pill) should be used. For chronic diarrhea with simultaneous Cold and Heat, Wu Mei Wan (Mume Pill) should be used.
Wei Ling Tang
(See formula under Abdominal Distension/Qi Gu) Add three jin of Sheng Jiang (Zingiberis Rhizoma Recens). Decoct in water to obtain half a cup, take warm. If Cold is severe with purging of undigested food, add Gan Jiang (Zingiberis Rhizoma) or Fu Zi (Aconiti Lateralis Radix Praeparata), or add Wuzhuyu (Evodiae Fructus). If Heat is severe with purging of intestinal mucus, remove Gui Zhi (Cinnamomi Ramulus) and add Huang Qin (Scutellariae Radix). If Deficiency is severe, add Ren Shen (Ginseng Radix et Rhizoma).
Fu Ling Si Ni Tang
Ren Shen (Ginseng Radix et Rhizoma, 2 qian), Gan Cao (Licorice Root and Rhizoma, 2 qian), Fu Ling (Poria, 3 qian), Gan Jiang (Zingiberis Rhizoma, 3 qian), Fu Zi (Aconiti Lateralis Radix Praeparata, 3 qian). Decoct in water to obtain half a cup, take warm. Add Banxia (Pinelliae Rhizoma) if vomiting occurs.
Tong Mai Si Ni Tang
Gan Jiang (Zingiberis Rhizoma, 5 qian), Fu Zi (Aconiti Lateralis Radix Praeparata, 3 qian), Gan Cao (Licorice Root and Rhizoma, 3 qian, honey-fried). Decoct in water to obtain half a cup, take warm.
Jia Wei Li Zhong Tang (Modified Regulate the Middle Decoction)
Ren Shen (Ginseng Radix et Rhizoma, 3 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 3 qian), Gan Jiang (Zingiberis Rhizoma, 2 qian), Gan Cao (Licorice Root and Rhizoma, 2 qian), Fu Ling (Poria, 3 qian), Shan Yao (Dioscoreae Rhizoma, 3 qian), Bian Dou (Lablab Semen Album, 3 qian). This formula is suitable for diarrhea caused by Spleen Deficiency.
Si Shen Wan (Four Spirits Pill)
Bu Gu Zhi (Psoraleae Fructus, 4 liang, wine-stir-fried), Rou Dou Kou (Myristicae Semen, baked in flour to remove oil), Wu Wei Zi (Schisandrae Fructus) (each 2 liang), Wuzhuyu (Evodiae Fructus, 1 liang, soaked in decoction). Boil eighty-one Da Zao (Jujubae Fructus) and four liang of Sheng Jiang (Zingiberis Rhizoma Recens) together until soft. Remove skin and seeds, mix with other powders to form pills the size of Sophora seeds. Take 4 qian with rice broth before sleep. Removing Rou Dou Kou and adding Ren Shen (Ginseng Radix et Rhizoma), Fu Ling (Poria), Gan Jiang (Zingiberis Rhizoma), Fu Zi (Aconiti Lateralis Radix Praeparata), and Ying Su Qiao (Papaveris Capsulum), pilled with rice broth, yields even better efficacy.
Wu Mei Wan (Mume Pill)
Wu Mei (Mume Fructus, 93 pieces), Xi Xin (Asari Radix et Rhizoma, 6 qian), Gan Jiang (Zingiberis Rhizoma, 1 liang), Huang Lian (Coptidis Rhizoma, 1 liang 6 qian), Shu Jiao (Zanthoxyli Pericarpium, 4 qian, stir-fried), Dang Gui (Angelicae Sinensis Radix, 4 qian), Gui Zhi (Cinnamomi Ramulus, 6 qian), Fu Zi (Aconiti Lateralis Radix Praeparata, 6 qian), Ren Shen (Ginseng Radix et Rhizoma, 6 qian), Huang Bo (Phellodendri Cortex, 6 qian). Grind each into powder. Soak Wu Mei (Mume Fructus) in vinegar overnight, remove pits, steam over rice until cooked, and mash into a paste. Mix well with the medicinal powders, add refined honey, and pound one thousand times. Form pills the size of Sophora seeds. Take ten pills mixed with white drink (rice broth/warm water) after meals, three times daily, gradually increasing to twenty pills.