梅核气者,似呃逆而非呃逆,系痰气窒塞于咽喉之间,咯之不出,咽之不下,如
梅核之状,故俗谓之梅核
气。江南之地比比云之,故从而附此。盖湿热痰气郁结而然,治法不外开郁顺气消痰而已。
有用吐法而愈者。药用二陈汤加川芎、香附、山栀、枳壳、槟榔、浓朴、条芩之类。
(《仁斋》)加味二陈汤 治梅核气不能饮食。
半夏(制) 陈皮 茯苓(各一钱) 甘草(三分) 黄芩 枳壳 萝卜子 苏子(各八分)
山栀(一钱) 白豆蔻仁(少许)
上水二盏、姜二片,煎八分,食远徐徐服。
(《秘方》)法制硝糟汤 治梅核气如神。
腊糟(不下水者,一斤) 朴硝(净者,半斤)
上二味和匀,用新瓷罐收贮密封,置净处。每遇患者,只取二三匙,煎汤一盏,徐徐饮
之自愈。不愈再服,无不神效。
《内经》曰∶三阳结谓之嗝,又曰∶少阳所至为呕,涌溢,食不下。食不得入,
是有火也。
巢氏《病源》云∶阴阳不和,则三焦隔绝。三焦隔绝,则津液不利,故令气塞不
调也,是以成噎。此由忧思所致。忧患则气结,气结则不宣流,使塞而噎。噎者,噎
塞不通也。
《针经》云∶怒气所至,食则气逆而不下,劳气所至为咽噎喘促,思气所至为中痞,三
焦闭塞,咽嗌不利。
丹溪曰∶大率属血少气虚有痰,血液枯槁,则痰涎凝滞,咽喉窒塞,食不能下,
或食下则胃脘当心而痛。此皆血少痰凝之明验也。
梅核气,症状类似呃逆但并非真正的呃逆,是由于痰气在咽喉之间阻滞堵塞,咳吐不出来,吞咽不下去,感觉像有一颗梅子核卡在那里,所以民间称之为梅核气。江南地区这种病很常见,因此在此加以附述。这通常是因为湿热、痰气和气机郁结所致,治疗方法不外乎疏解郁结、顺理气机、消除痰浊而已。
有的患者使用催吐法而痊愈。用药可用二陈汤(燥湿化痰、理气和中)加川芎、香附、山栀、枳壳、槟榔、厚朴、黄芩等药物。(出自《仁斋》)加味二陈汤:治疗梅核气导致无法进食。
半夏(制过的)一钱,陈皮一钱,茯苓一钱,甘草三分,黄芩八分,枳壳八分,萝卜子(莱菔子)八分,苏子八分,山栀一钱,白豆蔻仁少许。
以上药物加水两盏,生姜两片,煎煮至八分满,饭后慢慢服用。
(出自《秘方》)法制硝糟汤:治疗梅核气效果神奇。
腊糟(不渗水的陈年酒糟)一斤,朴硝(纯净的芒硝)半斤。
将这两味药混合均匀,用新的瓷罐收存并密封,放在干净的地方。每当遇到患者,只取二三匙,煎成一盏汤,慢慢喝下即可自愈。如果没好再服,无不神效。
《黄帝内经》说:三阳经邪气结聚称为噎膈,又说:少阳经病变严重时会出现呕吐、涌溢、食物难以下咽。食物不能入口,这是因为有火邪。
巢元方《诸病源候论》说:阴阳不和,会导致三焦隔绝不通。三焦隔绝不通,津液运行不利,从而导致气机阻塞不调,因此形成噎证。这是由忧思情绪引起的。忧患会导致气机郁结,气机郁结则不能宣通流动,使得气机阻塞而发生噎塞。噎,就是噎塞不通的意思。
《针经》说:怒气发作时,进食后气机上逆而不能下行;劳倦之气发作会导致咽喉噎塞、气喘急促;思虑过度会导致中脘痞闷;三焦闭塞,咽喉不利。
朱丹溪说:大率属于血少气虚且有痰,血液枯槁,导致痰涎凝滞,咽喉堵塞,食物不能下咽,或者食物吃下去后胃脘部当心处疼痛。这都是血少痰凝的明显证据。
Meiheqi (Plum-pit Qi), a condition resembling hiccup but not being true hiccup, is caused by the obstruction and blockage of phlegm and qi in the throat. It feels as if a plum pit is stuck there: it cannot be coughed out nor swallowed down. Hence, it is commonly called Meiheqi (Plum-pit Qi). This condition is prevalent in the Jiangnan region, so it is included here for reference. Generally, it arises from the stagnation and accumulation of damp-heat, phlegm, and qi. The treatment principle involves resolving stagnation, regulating qi, and eliminating phlegm.
Some patients were cured using the emetic method. The prescription used is Erchen Tang (Two-Aged Decoction) added with Chuanxiong Rhizoma (Chuanxiong), Cyperi Rhizoma (Xiangfu), Gardeniae Fructus (Shanzhi), Aurantii Fructus (Zhiqiao), Arecae Semen (Binglang), Magnoliae Officinalis Cortex (Houpo), and Scutellariae Radix (Huangqin). (From *Renzhai*) Jiawei Erchen Tang (Modified Two-Aged Decoction): Treats Meiheqi accompanied by inability to eat.
Banxia (Prepared Pinellia Tuber) 1 qian, Chenpi (Aged Tangerine Peel) 1 qian, Fuling (Poria) 1 qian, Gancao (Licorice Root) 3 fen, Huangqin (Scutellaria Root) 8 fen, Zhiqiao (Bitter Orange Fruit) 8 fen, Luoboziren (Radish Seed) 8 fen, Suzi (Perilla Seed) 8 fen, Shanzhi (Gardenia Fruit) 1 qian, Baiddoukouren (Cardamom Seed) a small amount.
Add two cups of water and two slices of ginger, decoct until reduced to eight-tenths, and take slowly after meals.
(From *Mifang*) Fazhi Xiaozao Tang (Processed Wine Lees and Niter Decoction): Miraculously treats Meiheqi.
Lazao (Old wine lees that do not leak water) 1 jin, Puxiao (Pure Niter/Mirabilite) 0.5 jin.
Mix these two ingredients evenly, store them in a new porcelain jar, seal tightly, and keep in a clean place. Whenever treating a patient, take only two or three spoonsful, decoct with one cup of water, and drink slowly; self-healing will occur. If not healed, take again; no case fails to show miraculous effect.
*Neijing* (The Yellow Emperor's Inner Canon) states: "Accumulation in the three yang meridians is called Ge (dysphagia/obstruction)." It also states: "Manifestations of Shaoyang include vomiting, surging overflow, and inability to eat." Inability to ingest food indicates the presence of fire.
Chao Yuanfang's *Zhubing Yuanhou Lun* (Treatise on the Pathogenesis and Manifestations of All Diseases) states: "When yin and yang are disharmonious, the Sanjiao (Triple Burner) becomes isolated. When the Sanjiao is isolated, body fluids fail to circulate smoothly, causing qi obstruction and dysregulation, thus forming Ye (choking/dysphagia). This results from worry and overthinking. Anxiety causes qi stagnation; qi stagnation prevents free flow, leading to obstruction and choking. 'Ye' refers to the state of obstruction and blockage."
*Zhenjing* (The Classic of Acupuncture) states: "Anger leads to qi rebellion upon eating, preventing downward movement. Labor-induced qi issues cause throat choking and panting. Thought-induced qi issues cause epigastric fullness. Obstruction of the Sanjiao leads to throat discomfort."
Zhu Danxi stated: "Generally, this belongs to blood deficiency and qi deficiency with phlegm. When blood is withered, phlegm-saliva stagnates, blocking the throat, making swallowing difficult. Or, pain occurs in the epigastrium directly behind the heart after eating. These are clear evidences of blood deficiency and phlegm coagulation."