滑石(六两) 甘草(一两) 吴茱萸(汤炮过,一两)
此亦治湿热吞酸之方也。
滑石寒而淡,寒能胜热,淡能导利,故足以治湿热。吴茱萸味辛性热,能反佐以从治。
甘草性温气平,能和中而泻火。
叙曰∶痞,虚中之实也。许学士云∶邪之所凑,其气必虚,留而不去,其病则实。故治
痞者,一补一消。考方二首,表昔人之法尔。
枳实(麸炒) 黄连(炒,各五钱) 浓朴(姜炒,四钱) 半夏曲 人参 白术(各
三钱)
干生姜 甘草 茯苓 麦芽(各二钱)
心下虚痞,恶食懒倦,右关脉弦者,此方主之。
痞,与“否”同,不通泰也。《易》曰∶天地不交而成痞。故肺气不降,脾气不运,升
降不通,而名痞也。脾为邪气乘之,不足以胜谷,故令恶食。脾者卑脏,役气于四肢,而后
肢体强健,脾病则不能致气于肢体,故令懒倦。肝脉也,木来克土,故令右关脉弦。是方也,
枳实、黄连、浓朴之苦,可以下气。半夏曲、干生姜之辛,可以行滞。人参、甘草、白术、
茯苓之甘,可使健脾。麦 善消,则可以推陈而致新矣。是疾也,功在慎口。经曰∶阴之五
宫,伤在五味,奈何不慎乎。
木香 生姜 陈皮(各六分) 柴胡(七分) 当归梢 枳实(各四分) 半夏(一钱
五分)
红花(二分) 草豆蔻 炙甘草(各二钱)
忧气郁结,腹皮里微痛,心下痞满,不思饮食,此方主之。
上件病证,即六朝之医所谓气膈也,今人谓之气痞耳。经曰∶脾主行气于三阴,三阴之
脉皆行腹里,今忧气郁结,营卫之行涩,故令腹皮里微痛,心下痞满者,升降之道乖也。不
思饮食者,忧气伤脾也。辛香可以化气,故用木香、豆蔻、生姜、陈皮、半夏之辈以主之,
升降者,交泰之道也,故用柴胡之辛以升之,枳实之苦以降之,营卫涩而后腹皮痛,故用归
尾、红花以和营,炙甘草以和卫。
滑石(六两) 甘草(一两) 吴茱萸(用汤炮制过,一两)
这也是治疗湿热导致的吞酸(胃酸上逆伴有灼热感)的方剂。
滑石性寒味淡,寒能清热,淡能通利水道,所以足以治疗湿热证。吴茱萸味辛性热,能起到反佐的作用以顺从病势而治。
甘草性温气平,能调和脾胃并清泻火热。
序言说:痞证,是虚中夹实的病证。许学士说:邪气聚集的地方,正气必然虚弱;邪气停留不去,病证就表现为实。所以治疗痞证,要采用一补一消的方法。考证这两个方子,不过是展示前人的治法罢了。
枳实(麸皮炒) 黄连(炒,各五钱) 浓朴(姜汁炒,四钱) 半夏曲 人参 白术(各三钱)
干生姜 甘草 茯苓 麦芽(各二钱)
心下部感觉空虚痞塞,厌恶进食,懒于疲倦,右关脉呈弦象的,此方主治。
“痞”与“否”字相同,指不通畅、不舒泰。《易经》说:天地之气不交合而形成痞塞。所以肺气不下降,脾气不运化,升降通道不通,因而称为痞证。脾脏被邪气侵犯,不足以消化食物,所以导致厌恶进食。脾属于卑湿之脏,负责将精气输送到四肢,然后肢体才能强健,脾有病就不能将精气送达肢体,所以导致懒倦。这是肝脉的表现,木气克制土气,所以导致右关脉呈弦象。这个方子中,枳实、黄连、浓朴的苦味,可以下气;半夏曲、干生姜的辛味,可以行气导滞;人参、甘草、白术、茯苓的甘味,可以使脾气健运;麦芽善于消食,就可以推陈出新。这个疾病,功效在于慎饮食。经书说:五脏受到损伤,往往是因为五味过度,怎么能不慎呢?
木香 生姜 陈皮(各六分) 柴胡(七分) 当归梢 枳实(各四分) 半夏(一钱五分)
红花(二分) 草豆蔻 炙甘草(各二钱)
忧思气机郁结,腹壁内部轻微疼痛,心下部痞满,不想吃东西,此方主治。
上述病证,就是六朝时期医生所说的“气膈”,现在人称之为“气痞”。经书说:脾主将气运行于三阴经,三阴经的经脉都行走于腹部内部,现在因忧思气机郁结,营卫之气运行涩滞,所以导致腹壁内部轻微疼痛,心下部痞满,这是升降之道失常。不想吃东西,是因为忧思伤及脾脏。辛香药物可以化气,所以用木香、豆蔻、生姜、陈皮、半夏这类药物来主导治疗;升降,是阴阳交泰的道理,所以用柴胡的辛味来升提,枳实的苦味来降泄;营卫涩滞而后导致腹壁疼痛,所以用归尾、红花来调和营血,炙甘草来调和卫气。
Hua Shi (Lapis Talcum, 6 liang) Gan Cao (Radix Glycyrrhizae, 1 liang) Wu Zhu Yu (Fructus Evodiae, processed with decoction, 1 liang)
This is also a formula for treating acid regurgitation caused by damp-heat.
Hua Shi is cold and bland; its coldness can overcome heat, and its blandness can promote diuresis, thus it is sufficient to treat damp-heat. Wu Zhu Yu is acrid and hot in nature, serving as an antipodeal agent to treat according to the disease's tendency.
Gan Cao is warm in nature and neutral in qi, capable of harmonizing the middle jiao and clearing fire.
Preface: Pi syndrome (epigastric fullness and stuffiness) is a condition of excess within deficiency. Scholar Xu stated: Where pathogenic factors gather, the healthy qi must be deficient; if they remain and do not depart, the pathology manifests as excess. Therefore, treating Pi syndrome requires one method of tonification and one of purgation. Examining these two formulas merely demonstrates the methods of ancient physicians.
Zhi Shi (Fructus Aurantii Immaturus, bran-fried) Huang Lian (Rhizoma Coptidis, fried, each 5 qian) Hou Po (Cortex Magnoliae Officinalis, ginger-juice fried, 4 qian) Ban Xia Qu (Massa Medicata Fermentata) Ren Shen (Radix Ginseng) Bai Zhu (Rhizoma Atractylodis Macrocephalae, each 3 qian)
Gan Sheng Jiang (Rhizoma Zingiberis Recens, dried) Gan Cao (Radix Glycyrrhizae) Fu Ling (Poria) Mai Ya (Fructus Hordei Germinatus, each 2 qian)
For emptiness and stuffiness in the epigastrium, aversion to food, lethargy, and a wiry pulse at the right Guan position, this formula is indicated.
"Pi" is synonymous with "Pi" (obstruction), meaning lack of smooth flow and comfort. The *I Ching* states: When heaven and earth do not interact, obstruction occurs. Thus, when Lung Qi fails to descend and Spleen Qi fails to transform, the ascending and descending pathways are blocked, hence named Pi syndrome. When the Spleen is invaded by pathogenic factors, it cannot adequately digest food, leading to aversion to eating. The Spleen is a lowly organ that distributes qi to the four limbs, enabling them to be strong; when diseased, it cannot send qi to the limbs, causing lethargy. This reflects the Liver pulse; Wood overacting on Earth causes the right Guan pulse to become wiry. In this formula, the bitterness of Zhi Shi, Huang Lian, and Hou Po can direct qi downward; the acridity of Ban Xia Qu and Gan Sheng Jiang can move stagnation; the sweetness of Ren Shen, Gan Cao, Bai Zhu, and Fu Ling can strengthen the Spleen; Mai Ya, good at digestion, can eliminate the old and generate the new. The efficacy in treating this disease lies in dietary caution. The Classics state: The five zang organs are injured by the five flavors; how can one not be cautious?
Mu Xiang (Radix Aucklandiae) Sheng Jiang (Rhizoma Zingiberis Recens) Chen Pi (Pericarpium Citri Reticulatae, each 6 fen) Chai Hu (Radix Bupleuri, 7 fen) Dang Gui Shao (Radix Angelicae Sinensis, tip) Zhi Shi (Fructus Aurantii Immaturus, each 4 fen) Ban Xia (Rhizoma Pinelliae, 1 qian 5 fen)
Hong Hua (Flos Carthami, 2 fen) Dou Kou (Semen Cardamomi Rotundum) Zhi Gan Cao (Radix Glycyrrhizae Preparata, each 2 qian)
For melancholy and qi stagnation, slight pain inside the abdominal wall, epigastric fullness and stuffiness, and loss of appetite, this formula is indicated.
The aforementioned symptoms correspond to what physicians in the Six Dynasties called "Qi Ge" (qi-type dysphagia/fullness), now known as "Qi Pi" (qi-type epigastric stuffiness). The Classics state: The Spleen governs the distribution of qi through the three Yin meridians, all of which traverse the interior of the abdomen. Now, due to melancholy and qi stagnation, the circulation of Ying and Wei qi becomes sluggish, causing slight pain inside the abdominal wall and epigastric fullness/stuffiness, indicating a disorder of the ascending and descending pathways. Loss of appetite results from melancholy injuring the Spleen. Acrid and aromatic herbs can transform qi; therefore, Mu Xiang, Dou Kou, Sheng Jiang, Chen Pi, and Ban Xia are used as main agents. Ascending and descending constitute the principle of Taiji interaction; thus, the acridity of Chai Hu is used to ascend, and the bitterness of Zhi Shi to descend. Since Ying and Wei sluggishness leads to abdominal wall pain, Gui Wei (tail of Radix Angelicae Sinensis) and Hong Hua are used to harmonize Ying blood, and Zhi Gan Cao to harmonize Wei qi.