噫而心下痞硬不利者,旋复代赭汤。若下利者,生姜泻心汤也。(方论见痞。)
〔云〕伤寒噫气者,何气使然?答曰∶胸中气不交故也。少阴经至胸中,交于厥阴,水火相传而有
声,故噫气也。宜如圣加枳实汤。
甘草 桔梗(各五钱) 枳实(炒,三钱)
上锉细,每服五钱,入五味子半钱,水煎服。
伤寒汗下后,喘而噫气者,宜如圣加人参藿香杏仁汤。
甘草 桔梗 人参 藿香 杏仁(各等分)
上锉细,每服五钱,水煎服。
伤寒大吐大下后,极虚,复极汗出者,以其人外气怫郁,复与之水以发其汗,因得哕。所以然者,胃中寒
冷故也。
胃中虚冷不能食者,饮水则哕,与小承气汤,入腹中不转矢气者,不可攻之,攻之必胀满不食,与水则哕。
(论见潮热。)
〔《本》〕渴而饮水呕者哕,食谷者哕。(论见胁痛。)阳明病,胃实不能食者,攻其热必哕。(论见胃实。)
湿家头汗出,背强恶寒,欲覆被向火者,下之早则哕。(论见体痛。)
太阳病,以火劫发汗,血气流溢,身黄欲衄,头汗腹满,谵语,甚者至哕,捻衣摸床,小便利者可治。(论
见头汗。)
伤寒哕而腹满,视其前后,知何部不利,利之则愈。
阳明胃实,脉弱浮大,短气,腹满胁痛,嗜卧,身黄小便难,有潮热,时时哕,脉浮者,小柴胡。若不尿,
腹满加哕者,不治。(论见胃实。)
出现呃逆(嗳气)且胃脘部痞塞坚硬、排便不畅的,使用旋复代赭汤。如果出现下利的症状,则使用生姜泻心汤。(方剂论述参见“痞证”章节。)
〔云〕伤寒病中出现呃逆(嗳气),是什么气导致的?回答是:因为胸中气机不交通的缘故。少阴经的气到达胸中,与厥阴经相交,水火之气相互传变而产生声音,所以出现呃逆(嗳气)。适宜使用如圣加枳实汤。
甘草 桔梗(各五钱) 枳实(炒制,三钱)
以上药材切碎,每次服用五钱,加入五味子半钱,用水煎煮后服用。
伤寒经过发汗或攻下治疗后,出现气喘并伴有呃逆(嗳气)的,适宜使用如圣加人参藿香杏仁汤。
甘草 桔梗 人参 藿香 杏仁(各等分)
以上药材切碎,每次服用五钱,用水煎煮后服用。
伤寒经过剧烈呕吐和攻下治疗后,人体极度虚弱,又出现极度出汗的情况,这是因为患者体表气机郁滞不畅,医生又给予饮水以试图发汗,因此导致哕(呃逆/干呕)。之所以这样,是因为胃中寒冷所致。
胃中虚冷不能进食的人,喝水就会引发哕(呃逆/干呕),此时应给予小承气汤;如果药入腹中后没有排气(矢气),则不可再行攻下,否则必然导致腹胀满、不能进食,给水则会引发哕(呃逆/干呕)。(相关论述参见“潮热”章节。)
〔《本草》/《本经》引文〕口渴而饮水后呕吐并伴有哕(呃逆/干呕)的,进食谷物也会引发哕(呃逆/干呕)。(相关论述参见“胁痛”章节。)阳明病,胃中有实热导致不能进食的,若强行清热攻下必会导致哕(呃逆/干呕)。(相关论述参见“胃实证”章节。)
患有湿病的患者,头部出汗,背部僵硬恶寒,想要盖被子靠近火源取暖的,如果过早使用攻下法,会导致哕(呃逆/干呕)。(相关论述参见“身体疼痛”章节。)
太阳病,用火法强行发汗,导致血气流溢,身体发黄欲衄血,头部出汗腹部胀满,胡言乱语,严重的甚至出现哕(呃逆/干呕),搓弄衣角、抚摸床沿,如果小便通畅的,可以治疗。(相关论述参见“头汗”章节。)
伤寒出现哕(呃逆/干呕)且腹部胀满,观察其前阴和后阴,知道哪一部分不通利,通利该部分即可痊愈。
阳明胃实证,脉象弱而浮大,短气,腹部胀满胁肋疼痛,嗜睡,身体发黄小便困难,有潮热,时常出现哕(呃逆/干呕),脉浮的,使用小柴胡汤。如果不排尿,腹部胀满加重并出现哕(呃逆/干呕)的,属于不治之症。(相关论述参见“胃实证”章节。)
When belching (Yi) is accompanied by epigastric fullness and hardness with difficult defecation, Xuanfu Daizhe Tang (Inula and Hematite Decoction) should be used. If diarrhea occurs, Shengjiang Xiexin Tang (Fresh Ginger Decoction to Drain the Epigastrium) is indicated. (The discussion on these formulas can be found in the section on "Pi Syndrome" [Epigastric Fullness].)
[Question] What causes belching (Yi qi) in Shanghan (Cold Damage)?
[Answer] It is caused by the failure of Qi to communicate in the chest. The Shaoyin meridian reaches the chest and intersects with the Jueyin meridian; the transmission between Water and Fire generates sound, resulting in belching (Yi qi). Rusheng Jia Zhishi Tang (Rusheng Decoction with Added Immature Bitter Orange) is appropriate.
Gancao (Licorice Root), Jiegeng (Platycodon Root) (each 5 qian), Zhishi (Immature Bitter Orange) (stir-fried, 3 qian).
Crush the herbs finely. Take 5 qian per dose, add Banwei Zi (Schisandra Berry) 0.5 qian, decoct with water, and take orally.
After sweating or purging treatments for Shanghan (Cold Damage), if panting and belching (Yi qi) occur, Rusheng Jia Renshen Huoxiang Xingren Tang (Rusheng Decoction with Added Ginseng, Agastache, and Apricot Seed) is appropriate.
Gancao (Licorice Root), Jiegeng (Platycodon Root), Renshen (Ginseng Root), Huoxiang (Patchouli Herb), Xingren (Apricot Seed) (equal parts).
Crush the herbs finely. Take 5 qian per dose, decoct with water, and take orally.
After severe vomiting and purging in Shanghan (Cold Damage), the body becomes extremely deficient. If excessive sweating then occurs, it is because the exterior Qi was already constrained and stagnant, and giving water to induce further sweating led to this condition. Thus, Yue (hiccups/dry heaves) results. This happens because of cold deficiency in the Stomach.
When the Stomach is deficient and cold, preventing food intake, drinking water will trigger Yue (hiccups/dry heaves). In such cases, Xiaochengqi Tang (Minor Order the Yang Decoction) may be given. However, if after ingestion there is no passage of flatus (Shiqi), do not attack with purgatives. Attacking will inevitably cause abdominal fullness and inability to eat, and giving water will trigger Yue (hiccups/dry heaves). (See the discussion on "Chao Re" [Tidal Fever].)
[From Ben Cao/Ben Jing] Thirst accompanied by vomiting and Yue (hiccups/dry heaves) after drinking water, or Yue (hiccups/dry heaves) after eating grain, indicates a specific pathology. (See the discussion on "Xie Tong" [Hypochondriac Pain].) In Yangming disease, if the Stomach has excess heat causing an inability to eat, attacking the heat will inevitably lead to Yue (hiccups/dry heaves). (See the discussion on "Wei Shi" [Stomach Excess].)
In patients with Dampness who have head sweating, back stiffness, aversion to cold, and desire to cover themselves with blankets near fire, premature purging will result in Yue (hiccups/dry heaves). (See the discussion on "Ti Tong" [Body Pain].)
In Taiyang disease, if fire therapy is used to force sweating, causing blood and Qi to overflow, leading to yellowing of the body, tendency for nasal bleeding, head sweating, abdominal fullness, delirium, and in severe cases Yue (hiccups/dry heaves), picking at clothes, and touching the bed, if urination is free, the condition is treatable. (See the discussion on "Tou Han" [Head Sweating].)
In Shanghan (Cold Damage), if Yue (hiccups/dry heaves) occurs with abdominal fullness, examine the anterior and posterior orifices to determine which is obstructed. Relieving the obstruction will lead to recovery.
In Yangming Stomach Excess, with a weak yet floating and large pulse, shortness of breath, abdominal fullness, hypochondriac pain, lethargy, jaundice, difficulty in urination, tidal fever, frequent Yue (hiccups/dry heaves), and a floating pulse, Xiaochaihu Tang (Minor Bupleurum Decoction) is indicated. If there is no urination, and abdominal fullness worsens with the addition of Yue (hiccups/dry heaves), the condition is untreatable. (See the discussion on "Wei Shi" [Stomach Excess].)