有物有声谓之呕,有物无声吐证名,无物有声谓哕证,分别医治中病情。
[注]
吐证有三,曰呕,曰吐,曰哕,
古人谓呕属阳明,有声有物,气血俱病也,
吐属太阳,有物无声,血病也,
哕属少阳,有声无物,气病也,
独李杲谓呕吐哕俱属胃虚弱,
洁古老人又从三焦以分气积寒之三因,然皆不外诸逆上冲也,
治者能分虚实别寒热以治之,自无不曲中病情矣。
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吐证门
乳食过饱蓄胃中,乳片不化吐频频,身热面黄腹膨胀,消乳保和有神功。
[注]
伤乳者,因乳食过饱,停蓄胃中,以致运化不及,
吐多乳片,犹如物盛满而上溢也,
其证身热面黄,吐腹膨胀,
治宜消乳丸保和丸化其宿乳,安胃和中,节其乳食,自然止也。
(消乳丸) 香附二两制 神麴炒 麦芽各一两炒 陈皮八钱 缩砂仁炒
甘草各五钱炙 以上为细末,滴水为丸如粟米大,量儿大小服之,姜汤化下。
(保和丸)
南山查二两 神麴一两炒 茯苓 半夏各一两姜制 连翘去心 陈皮 莱
菔子各五钱炒 以上为细末,面糊为丸,麦芽汤化服。
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吐证门
过食伤胃腹胀热,恶食口臭吐酸粘,眼胞虚浮身潮热,须服三棱和胃煎。
[注]
伤食吐者,因小儿饮食无节,过食油腻面食等物,以致壅塞中脘而成也,
其证肚腹胀热,恶食口臭,频吐酸粘,眼胞虚浮,身体潮热,
治宜清胃和中为主,先用三棱丸止其吐,再用和胃汤化其滞,而病渐愈矣。
(三棱丸) 三棱煨 陈皮 半夏姜制 神麴各一两炒 黄连姜制
枳实麸炒 丁香各五钱 以上研细末,面和为丸,如黄米大,
每服二十丸,食后姜汤下。
(和胃汤) 陈皮 半夏姜制 缩砂仁研 苍术炒 厚朴姜制 藿香叶
香附炒 甘草炙 山查 神麴炒 引用生姜水煎服。
(方歌)
和胃汤治呕吐频,陈皮半夏缩砂仁,苍术厚朴藿香叶,香附甘草山查神
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吐证门
有实物且有声音的称为“呕”,有实物但无声音的称为“吐”,无实物但有声音的称为“哕”,治疗时需根据病情分别处理。
[注]
呕吐类病症有三种,即“呕”、“吐”、“哕”。
古人认为“呕”属于阳明病(阳明经受邪所致的病证),特点是既有声音又有实物,是气血均受病的表现;
“吐”属于太阳病(太阳经受邪所致的病证),特点是有实物而无声音,是血分受病的表现;
“哕”属于少阳病(少阳经受邪所致的病证),特点是有声音而无实物,是气分受病的表现。
唯独李杲(金元四大家之一)认为“呕、吐、哕”都归属于胃气虚弱。
洁古老人(张元素)又从三焦(上焦、中焦、下焦)的角度区分气滞、积食、寒邪这三种病因,然而这些观点都不外乎各种气逆上冲的病机。
治疗者若能辨别虚实、区分寒热来进行治疗,自然能准确地契合病情。
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呕吐病症门类
乳食过饱蓄积在胃中,乳汁片状不消化而频繁呕吐,身体发热、面色萎黄、腹部胀满,服用消乳丸和保和丸具有神奇功效。
[注]
伤乳症,是因为乳食过量,停滞蓄积在胃中,导致脾胃运化功能不及,
呕吐物中多含有未消化的乳片,就像容器盛满后向上溢出一样,
其症状表现为身体发热、面色萎黄、呕吐且腹部胀满,
治疗宜采用消乳丸和保和丸来化解滞留的乳汁,安顿胃气、调和脾胃,并节制乳食摄入,疾病自然会停止。
(消乳丸) 香附二两(制) 神曲一两(炒) 麦芽一两(炒) 陈皮八钱 缩砂仁五钱(炒) 甘草五钱(炙) 以上药物研为细末,滴水制成如粟米大小的丸剂,根据婴儿大小调整剂量服用,用姜汤送服化开。
(保和丸)
山楂二两 神曲一两(炒) 茯苓一两 半夏一两(姜制) 连翘去心 陈皮五钱 莱菔子五钱(炒) 以上药物研为细末,用面糊制成丸剂,用麦芽汤送服化开。
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呕吐病症门类
饮食过量损伤胃部导致腹胀发热,厌恶食物、口臭、呕吐酸粘液体,眼睑虚浮、身体定时发热,必须服用三棱和胃煎。
[注]
伤食吐症,是因为小儿饮食没有节制,过量食用油腻面食等食物,导致气机壅塞在中脘部位而形成,
其症状表现为肚腹胀满发热、厌恶食物、口臭,频繁呕吐酸粘液体,眼睑虚浮,身体定时发热,
治疗应以清胃热、调和中焦为主,先用三棱丸止住呕吐,再用和胃汤化解积滞,病情就会逐渐痊愈。
(三棱丸) 三棱一两(煨) 陈皮一两 半夏一两(姜制) 神曲一两(炒) 黄连一两(姜制) 枳实一两(麸炒) 丁香五钱 以上药物研成细末,用面调和制成如黄米大小的丸剂,
每次服用二十丸,饭后用姜汤送服。
(和胃汤) 陈皮 半夏(姜制) 缩砂仁(研) 苍术(炒) 厚朴(姜制) 藿香叶 香附(炒) 甘草(炙) 山楂 神曲(炒) 引用生姜水煎服。
(方歌)
和胃汤治疗频繁呕吐,包含陈皮、半夏、缩砂仁,苍术、厚朴、藿香叶,香附、甘草、山楂、神曲。
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呕吐病症门类
There is a distinction between vomiting, spitting up, and hiccups based on the presence of sound and matter: "Ou" (vomiting with sound and matter), "Tu" (spitting up with matter but no sound), and "Yue" (hiccups with sound but no matter). Treatment must be tailored to the specific condition.
[Note]
There are three types of regurgitation disorders: Ou (vomiting), Tu (spitting up), and Yue (hiccups).
Ancient texts state that Ou belongs to Yangming disease (diseases affecting the Yangming meridians), characterized by both sound and expelled matter, indicating pathology in both Qi and Blood.
Tu belongs to Taiyang disease (diseases affecting the Taiyang meridians), characterized by expelled matter without sound, indicating pathology primarily in Blood.
Yue belongs to Shaoyang disease (diseases affecting the Shaoyang meridians), characterized by sound without expelled matter, indicating pathology primarily in Qi.
However, Li Gao (a prominent physician of the Jin-Yuan period) argued that Ou, Tu, and Yue all stem from Stomach Qi deficiency.
Jiegu Laoren (Zhang Yuansu) differentiated these conditions based on the Sanjiao (Triple Burner) regarding causes such as Qi stagnation, food accumulation, and Cold. Nevertheless, all these views revolve around the mechanism of rebellious Qi rushing upward.
If practitioners can distinguish between Deficiency and Excess, and Cold and Heat, their treatment will naturally align accurately with the patient's condition.
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Category of Regurgitation Disorders
Excessive milk intake accumulates in the Stomach; undigested milk curds are frequently vomited. Symptoms include fever, sallow complexion, and abdominal distension. Xiaoru Wan (Milk-Digesting Pills) and Baohe Wan (Preserve Harmony Pills) are highly effective.
[Note]
Shangru syndrome (milk injury) occurs when excessive milk intake stagnates in the Stomach, overwhelming its transportation and transformation functions.
The vomitus contains many milk curds, resembling overflow from an overfilled container.
Symptoms include fever, sallow complexion, vomiting accompanied by abdominal distension.
Treatment should focus on using Xiaoru Wan and Baohe Wan to resolve retained milk, stabilize the Stomach, harmonize the Middle Jiao, and regulate milk intake, which will naturally stop the vomiting.
(Xiaoru Wan) Xiangfu (Cyperi Rhizoma) 2 liang (processed), Shenqu (Massa Medicata Fermentata) 1 liang (stir-fried), Maiya (Hordei Fructus Germinatus) 1 liang (stir-fried), Chenpi (Citri Reticulatae Pericarpium) 8 qian, Suosharen (Amomi Fructus Rotundus) 5 qian (stir-fried), Gancao (Glycyrrhizae Radix et Rhizoma) 5 qian (honey-fried). Grind all into fine powder, mix with water to form pills the size of millet seeds. Administer according to the infant's age and size, dissolved in Ginger Decoction.
(Baohe Wan) Shanzha (Crataegi Fructus) 2 liang, Shenqu (Massa Medicata Fermentata) 1 liang (stir-fried), Fuling (Poria) 1 liang, Banxia (Pinelliae Rhizoma) 1 liang (processed with Ginger), Lianqiao (Forsythiae Fructus) (de-veined), Chenpi (Citri Reticulatae Pericarpium) 5 qian, Laifuzi (Raphani Semen) 5 qian (stir-fried). Grind all into fine powder, bind with wheat paste to form pills. Administer dissolved in Maiya Tang (Barley Malt Decoction).
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Category of Regurgitation Disorders
Overeating damages the Stomach, causing abdominal distension and heat. Symptoms include aversion to food, foul breath, frequent vomiting of sour sticky fluid, puffy eyelids, and tidal fever. Sanleng Hewei Jian (Sanleng Harmonizing Stomach Decoction) is required.
[Note]
Shangshi Tu syndrome (food-injury vomiting) results from irregular eating habits in children, specifically excessive consumption of greasy foods and flour products, leading to obstruction in the Zhongwan region.
Symptoms include abdominal distension and heat, aversion to food, foul breath, frequent vomiting of sour sticky fluid, puffy eyelids, and tidal fever.
Treatment should prioritize clearing Stomach Heat and harmonizing the Middle Jiao. First, use Sanleng Wan to stop vomiting, then use Hewei Tang to resolve stagnation, leading to gradual recovery.
(Sanleng Wan) Sanleng (Sparganii Rhizoma) 1 liang (roasted), Chenpi (Citri Reticulatae Pericarpium) 1 liang, Banxia (Pinelliae Rhizoma) 1 liang (processed with Ginger), Shenqu (Massa Medicata Fermentata) 1 liang (stir-fried), Huanglian (Coptidis Rhizoma) 1 liang (processed with Ginger), Zhishi (Aurantii Fructus Immaturus) 1 liang (bran-fried), Dingxiang (Caryophylli Flos) 5 qian. Grind all into fine powder, bind with dough to form pills the size of broomcorn millet. Take 20 pills after meals, washed down with Ginger Decoction.
(Hewei Tang) Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma) (processed with Ginger), Suosharen (Amomi Fructus Rotundus) (ground), Cangzhu (Atractylodis Rhizoma) (stir-fried), Houpo (Magnoliae Officinalis Cortex) (processed with Ginger), Huoxiangye (Agastaches Herba), Xiangfu (Cyperi Rhizoma) (stir-fried), Gancao (Glycyrrhizae Radix et Rhizoma) (honey-fried), Shanzha (Crataegi Fructus), Shenqu (Massa Medicata Fermentata) (stir-fried). Add fresh ginger and water, decoct and take orally.
(Prescription Verse)
Hewei Tang treats frequent vomiting, containing Chenpi, Banxia, Suosharen; Cangzhu, Houpo, Huoxiangye; Xiangfu, Gancao, Shanzha, Shenqu.
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Category of Regurgitation Disorders