证
恶心者,无声无物,但心中欲吐不吐,欲呕不呕。虽曰恶心,
非心经之病。其病皆在胃口上,有虚,有热,有寒,有食,有痰。
治
治法∶虚者补之,热者清之,寒者温之,食与痰者,消之化
之。皆用生姜及姜汁,随症佐药,其效最速。
方
二陈汤(见痰门) 加姜汁炒芩、连,栀子治胃热恶心。
大半夏汤(即二陈汤去甘草加生姜) 治胃寒恶心
小半夏茯苓汤(即大半夏汤去陈皮倍加生姜) 治心中兀兀欲吐。
导痰汤(即二陈汤加南星、枳壳) 加竹茹、砂仁、姜炒黄连,治痰热呕吐,恶心气盛者。
脉
浮缓者生,沉涩者死。脉涩而小,血不足;脉大而弱,气不足。
证
夫翻胃者,朝食而暮吐,暮食而朝吐,或食已即吐者是也。膈噎者,谓五膈五噎也。五膈,忧、恚、寒、
热、气也;五噎,忧、思、劳、食、气也。膈者,在心脾之间,上下不通,若拒格之状也。或结于咽喉,时
觉有所碍,吐之不出,咽之不下,由气郁痰搏而然。久则渐妨饮食,而为膈也。噎者,饮食之际,气卒阻滞,饮
食不下,而为噎也。翻胃也,膈也,噎也,三者名虽不同,而其所受之病,则一而已。《内经》谓∶三阳结
谓之膈。三阳者,大肠、膀胱也。结,热结也。小肠热结则血脉燥;大肠热结则不能圊;膀胱
热结则津液涸;三阳既结,则前后闭结。下既不通,则反上行,所以噎食不下,纵下而复出也。此阳火不
下降而上行也。故经曰∶少阳所至为呕、涌溢、食不下,此理明矣。丹溪曰∶气之初病,其端
甚微。或因些小饮食不谨;或外冒风雨,内伤七情;或食味过浓,偏助阳气,积成膈热;或资禀充实,表
密无汗;或性急易怒,相火上炎,以致津液不行,清浊相干。气之为病,或痞或痛,或不思食,
或噫腐吞酸,或嘈杂呕哕,医者不求其本,便认为寒,遽以辛香燥
热之剂投之。时暂得快,以为神方。浓味仍前不节,七情反复相侵,旧病被劫暂开,浊液易子攒聚,或半月,
或一月,前症复作。如此延蔓,自气成积,自积成痰,此为痰为饮为吞酸之由也。良工未遇,燥剂又投,痰
挟瘀血,遂成窠囊,此为痞、为痛、为呕吐、噎膈、翻胃之症,次第而作也。犹谓虚而积寒,非寻常草木可疗,
竟以乌附佐助丹药,专意服饵。积而血液俱耗,胃脘干稿。其稿在上,近咽之下,水液可行,食物难进。间
或可入,食亦不多,名之曰噎。其稿在下,与胃相近,食虽可下,难尽入胃,良久复出,名之曰膈,亦曰翻胃。
治
治当养血生津,清痰降火,润燥补脾,抑肝开郁,庶使病邪易伏,胃气开通。虽然亦在病者之调摄耳,
吾观张鸡峰曰∶噎是神思间病,惟内观以自养,此言深中病情。
一《钩玄》云∶翻胃大约有四∶血证、气虚、有痰,有热。血虚者,脉必数而无力,以四物汤养血为主;
气虚者,脉必缓而无力,以四君子汤补气为主;有痰者,脉必滑数,以二陈汤为主;有热者,脉必数而有力,
以解毒汤主之。
一凡噎膈翻胃,悉用二陈汤加姜汁、竹沥、童便、韭汁之类,为主治。
一若胸中觉有热闷,加土炒黄芩、黄连、栝蒌仁、桔梗之类。
一若血虚瘦弱之人,合四物汤,少加杏仁泥、红花、童便、韭汁之类,仍不可缺。
一若朝食暮吐,暮食朝吐,或食下须臾即吐者,此胃可容受而脾不能传送也。或大小肠闭
结不通,食返而上奔也,加酒蒸大黄以润之。脾不磨者,加神曲、麦芽之类,以助其衰火也。
一若气虚肥白人膈噎者,合四君汤,亦加竹沥、姜汁为要药也。
一若七情郁结,成气噎者,加香附,抚芎、木香、槟榔、栝蒌仁、砂仁之类。
一若饮酒之人,加砂糖、驴尿入内服。
一若膈噎,大便燥结,用大黄,乃急则治其标之剂也。仍用四
物汤,加童便、姜汁,多饮牛羊乳为上策也。但不可以人乳代之,盖人乳内有饮食烹饪之火也。
一若气血两虚,则口中多出沫。但见沫大出者,必死。粪如羊屎不治,大肠无血故也。年过五十者不治。
一中年妇人翻胃,以四物汤,加带白陈皮,留尖杏仁、生甘草、酒红花浓煎,入驴尿,以防生虫,数帖而愈。
一治翻胃噎膈,用螃蟹洗净,入水中高四指,以香油一小酒盏
入水中,以二指捻白面撒水上,涎即出。次日去蟹,留水晒干涎为末,每服五分,淡烧酒下。
方
主方 治一切翻胃噎膈,为总司要药也。
韭汁(二两) 牛乳(一盏) 生姜(半两,取汁) 竹沥(半盏) 童便(一盏)
上五味和匀,顿暖服。或加入煎剂内,尤为至效。
顺气和中汤(云林制) 治呕吐翻胃,嘈杂吞酸。
半夏(制,六分) 白茯苓(七分) 白术(土炒,八分) 广皮(盐水浸,炒,一钱)
枳实(麸炒,五分) 甘草(炙,二分) 香附(醋炒,一钱) 山栀(姜汁炒黑,一钱) 神
曲(炒,六分) 砂仁(炒,三分) 黄连(姜汁浸,晒干,以猪胆汁拌炒,六分)
上锉一剂,生姜三片,长流水入娇泥搅,澄清,水一钟,煎至七分,入竹沥、童便、姜汁,不拘时,细
细温服。心胃痛,加姜汁三匙。如气虚,加人参、黄 各八分。如血虚,加当归七分,川芎五分。如恼怒或
气不伸舒,加乌药五分、木香三分。如胸膈饱闷,加萝卜子炒,六分。如心下嘈杂吞酸,加吴茱萸四分,
倍黄连、白术。如呕吐不止,加藿香七分。如大便闭结,加苏
子、麻仁、桃仁、杏仁,俱研如泥,一钱,再用白蜜,时时服之。
安中调气丸(云林制) 治一切翻胃痰膈之证。
广皮(二两) 半夏(姜制,一两) 白茯神(一两) 白术(土炒,二两) 枳实(麸
炒,一两) 苏子(炒,六钱) 川芎(五钱) 当归(酒洗,五钱) 白芍药(盐酒洗,炒,
八钱) 木香(一钱) 甘草(炙,三钱) 香附(三两,长流水浸三日,洗净炒,黄色) 神
曲(炒,一两) 黄连(姜汁浸,晒干,猪胆汁拌炒,一两) 白豆蔻(五钱,萝卜子炒,五钱)
上为细末,竹沥、姜汁打神曲糊为丸,如绿豆大。每服八十丸,不拘时,白汤送下,清米汤亦可。
四七调气汤(西园公方) 治七情四气,以致膈噎翻胃。
紫苏(一钱五分) 浓朴(姜汁炒,一钱五分) 茯苓(一钱五分) 半夏(一钱五分)
枳实(炒,一钱半) 砂仁(一钱五分) 苏子(炒,一钱五分) 陈皮(一钱五分) 甘草(五分)
上锉,生姜三片,水煎服。后以加味保和丸,加人参一两,砂仁二两,木香二两,服之收功。
四子调中汤〔批〕(按此方治翻胃专因气者) 治翻胃,或大小便闭,及痰气壅盛。
青皮(麸炒,五分) 陈皮(五分) 枳实(麸炒,一钱) 香附(炒,一钱) 黄连(姜
汁炒,七分) 半夏(制,二钱) 栝蒌仁(炒,一钱) 苏子(炒,一钱) 沉香(五分)
茯苓(五分) 桃仁(去皮尖,一钱半) 白芥子(炒,一钱) 木通(五分) 芒硝(五分)
上锉一剂,生姜五片,水煎稍热服。
神奇散(方外人传)〔批〕(按此方治翻胃血虚有火者) 治噎食翻胃,三阳枯竭。
当归(一钱) 川芎(七分) 白芍药(酒炒,一钱) 生地黄(二钱) 陈皮(八分)
砂仁(七分) 半夏(姜制,八分) 白茯苓(一钱) 白术(土炒) 香附(醋炒,一钱) 枳
实(炒,一钱) 乌梅(三个) 藿香(一钱) 赤茯苓(一钱) 槟榔(一钱) 木通(一钱)
猪苓(一钱) 黄芩(炒,一钱) 黄柏(酒炒,一钱) 知母(人乳拌炒,一钱) 赤芍药
(一钱) 天门冬(去心,一钱) 麦门冬(去心,一钱) 甘草(八分)
上锉一剂,水二钟,煎一钟,入童便一盏,服。
吕纯阳降笔传治翻胃方
藿香(一钱) 陈皮(一钱) 半夏(八分) 赤茯苓(一钱) 人参(一钱) 白豆蔻
(一钱) 苏子(炒,一钱) 浓朴(制,八分) 槟榔(八分) 枇杷叶(蜜炙,一钱) 白芥
子(炒,八分) 沉香(一钱) 良姜(三分) 官桂(二分) 丁皮(二分) 杵头糠(一撮)
上锉一剂,生姜三片,枣一枚,水二盏,煎八分服。
加味六君子汤 治脾胃大虚,以致膈噎不食。
六君子汤加炮干姜、白豆蔻、黄连、制吴茱萸。
回生养胃丹〔批〕(按此方治翻胃气虚有寒者) 治真元虚损,心胃不交,
精神耗散。脾脏受湿,饮食不纳,五味不成津液,反成痰涎,聚于中
脘,不能传道,以致大肠燥涩,小便反多而赤。或时呕吐酸水,久成翻胃结肠之证。
苍术(米泔水浸三日,洗净晒干,再换浸三日,四两) 莲肉(酒浸一宿,四两)
雄猪肚(一个,壁土揉擦洗净入苍术、莲肉在内,以线缝紧,用好酒煮烂,取入石口内
捣如泥,捻作小饼,烘干加后药) 南星(四两,细切,姜汁浸一宿,以伏龙肝同炒,去
伏龙肝用,或用黄土亦可) 半夏(四两,泡,晒干细切,好醋浸七日,蒸熟) 橘红(四
两,以灶心土炒,去土用) 粟米(四两,姜汁浸,蒸,焙) 人参(一两) 白术(一两
)白茯苓(一两) 浓朴(姜汁炒,一两) 蓬术(一两,醋炒) 荜澄茄(一两) 砂仁(一两)
三棱(一两,醋炒) 白豆蔻(一两) 谷芽(炒,一两) 麦芽(炒,一两) 甘草(一两
)丁香(五钱) 木香(五钱) 沉香(五钱)
上为末,稀面糊为丸,如梧大子。每服一百丸,空心时,陈米汤送下。
加味保和丸〔批〕(按此方治翻胃有热者) 治实热翻胃。
保和丸(三钱,方见伤食) 加姜汁浸炒黄连三钱、山楂肉三钱,共为
末,米糊为丸,如麻子大。每服六十丸,煎人参竹沥汤送下。
九仙夺命丹(秘方) 治翻胃痰涎壅盛。
南星(姜制,三钱) 半夏(姜制,五钱) 枯明矾(五钱) 枳壳(麸炒,一两) 浓
朴(姜制,五钱) 人参(三钱) 木香(四钱) 豆豉(洗,一两) 甘草(三钱) 加阿魏
(三钱) 糖球子(五钱)
上为末,老米打糊为饼如钱大,瓦上焙干,晴夜露过。每服一
饼,细嚼,以姜煎平胃散送下。
沉香降气丹(长葛李大尹传方)〔批〕(按此方治翻胃腹中积块者) 治翻胃腹中有积块。
黑牵牛(取头末,三两) 大黄(一两,酒蒸) 槟榔(一两) 当归(一两,酒浸)
良姜(三钱) 苍术(一两) 青皮(炒,一两) 陈皮(五钱) 乌药(一两) 砂仁(五钱)
枳壳(麸炒,一两) 枳实(麸炒,五钱) 香附(一两,炒) 沉香(三钱) 三棱(三钱,火
煨) 半夏(制,五钱) 木香(三钱) 莪术(三钱,火煨) 黄连(一两,姜汁炒) 黄芩(一两,酒炒)
上为末,酒糊为丸桐子大。每服六七十丸,淡姜汤送下。
木香顺气丸(俞九河传方)〔批〕(按此方治翻胃大便闭结者) 治翻胃大便闭结者。
沉香(五钱) 木香(三钱) 当归(一两,酒浸) 白茯苓(一两) 山药(一两) 郁
李仁(二两) 槟榔(二两) 菟丝子(一两,酒制) 牛膝(二两,酒浸) 枳壳(一两,面
炒) 独活(一两) 防风(一两) 火麻仁(二两) 大黄(酒蒸,五钱)
上为末,炼蜜为丸如梧子大。每服二十五丸,白滚汤下。
定生丹(秘方)〔批〕(按此方治定翻胃之生死者) 治噎膈翻胃。
雄黄(三钱) 朱砂(三钱) 阿魏(五分,箬焙) 砂(五分) 乳香(三钱) 半夏
(三钱) 木香(三钱) 沉香(一钱) 肉豆蔻(三钱) 绿豆(四十粒) 乌梅(四十个)
百草霜(三钱,为衣)
上为末,将乌梅以热汤泡令软,剥去核,研极烂,入药捣为丸,如弹子大,百草霜为衣,阴干。每
用一粒,噙化咽下,以姜汤嗽口,复以陈麦饼火烧熟,细嚼压之。噙药即燃官香一炷,如香尽
药未化者,难治;药先化香未尽者,可愈。按此方用之以定吉凶生死者。
养血助胃丸(云林制)〔批〕(按此方治翻胃收功保后之剂) 治呕吐翻胃,愈
后用此养元气,健脾胃,生血脉,调荣卫,清郁气,收功保后。
当归(酒洗,一两) 川芎(一两) 白芍(盐酒炒,一两二钱) 熟地黄(姜汁浸炒,
八钱) 人参(五钱) 白术(土炒,一两三钱) 白茯苓(六钱) 甘草(炙,三钱) 山药
(炒,一两) 莲肉(去皮心,一两) 扁豆(姜汁炒,六钱)
上为末,姜打神曲糊为丸如梧桐子大。每服六七十丸,空心白滚水下。
证候表现
恶心,是指没有声音也没有呕吐物,只是心中感觉想吐却吐不出来,想呕却呕不出来的状态。虽然名为“恶心”,但这并不是心经的病变。其病位都在胃脘之上,病因包括虚证、热证、寒证、食积和痰饮。
治疗方法
治疗原则是:虚证用补法,热证用清法,寒证用温法,食积与痰饮用消导化滞之法。这些情况都使用生姜及姜汁作为辅助药物,根据具体症状配合其他药物,疗效最为迅速。
方剂
二陈汤(参见痰饮门)加入姜汁炒制的黄芩、黄连以及栀子,用于治疗胃热引起的恶心。
大半夏汤(即二陈汤去掉甘草,加入生姜),用于治疗胃寒引起的恶心。
小半夏茯苓汤(即大半夏汤去掉陈皮,加倍加入生姜),用于治疗心中兀兀不安、想要呕吐的感觉。
导痰汤(即二陈汤加入天南星、枳壳),加入竹茹、砂仁、姜炒黄连,用于治疗痰热引起的呕吐,以及恶心且气逆较盛的情况。
脉象诊断
脉象浮缓者预后良好(生),脉象沉涩者预后不良(死)。脉象涩而细小的,说明血不足;脉象大而无力的,说明气不足。
证候表现
所谓翻胃,是指早上吃的食物晚上吐出来,晚上吃的食物早上吐出来,或者吃完立刻吐出来的病症。膈噎,指的是五膈和五噎。五膈,是由忧、怒、寒、热、气五种因素引起;五噎,是由忧、思、劳、食、气五种因素引起。“膈”的病位在心脾之间,上下不通畅,就像被阻挡拒绝一样。有的结在咽喉部,时常觉得有阻碍感,吐不出来,咽不下去,这是由于气郁结、痰搏结所致。时间久了逐渐妨碍饮食,就形成了“膈”。 “噎”是指在进食的时候,气突然阻滞,导致饮食无法下行,从而形成“噎”。“翻胃”、“膈”、“噎”这三个名称虽然不同,但它们所受的病源是一样的。《内经》说:“三阳结谓之膈。”所谓的三阳,指的是大肠和膀胱(注:此处原文可能有误或特指,通常三阳指太阳、阳明、少阳,但原文解释为大肠膀胱,依原文翻译)。结,指的是热结。小肠热结则血脉干燥;大肠热结则不能排便;膀胱热结则津液枯竭。三阳既已结滞,则大小便闭塞不通。下部既然不通,气机反而向上逆行,所以出现吞咽困难、食物不下,即使勉强吃下也会再次吐出。这是阳火不下降反而上行所致。所以医经说:“少阳之气至,表现为呕吐、涌溢、饮食不下”,这个道理是很明确的。朱丹溪说:“气病初起时,征兆非常微小。”可能是因为一点点的饮食不慎;或者是外受风雨侵袭,内伤七情;或者是口味过重,偏助阳气,积聚成膈热;或者是体质充实,表密无汗;或者是性格急躁易怒,相火上炎,导致津液不行,清浊之气相互干扰。气机生病,可能出现痞满或疼痛,或不思饮食,或嗳腐吞酸,或嘈杂呕哕。医生如果不探求病根,就认为是寒证,急忙投以辛香燥热的药剂。暂时感到舒服,就以为是神方。但如果浓味饮食依然不节制,七情反复侵扰,旧病被强行压制后暂时缓解,浊液容易重新聚集,或者半个月,或者一个月,之前的症状又发作了。这样蔓延下去,由气滞变成积滞,由积滞变成痰饮,这就是产生痰饮、吞酸的原因。遇到良医之前,如果再次投用燥热药剂,痰挟带瘀血,遂形成窠囊,这就依次产生了痞、痛、呕吐、噎膈、翻胃等症状。还自认为是虚寒积滞,认为不是寻常草木药所能治疗的,竟然用乌头、附子辅助丹药,专心服用。久而久之,血液耗损,胃脘干枯。如果干枯在上部,靠近咽喉之下,水液还可以通行,但食物难以下咽。偶尔能进入,吃得也不多,这叫“噎”。如果干枯在下部,靠近胃部,食物虽然可以下行,但难以完全进入胃中,过了很久又吐出来,这叫“膈”,也叫“翻胃”。
治疗方法
治疗应当养血生津,清化痰热,降火润燥,补脾抑肝,开解郁结,这样才能使病邪容易伏藏,胃气得以通畅。虽然如此,也在于患者自身的调养。我看张鸡峰说过:“噎是精神意识层面的病,只有靠内观来自我修养”,这句话深深切中了病情。
《钩玄》中说:翻胃大约有四种类型:血证、气虚、有痰、有热。血虚的人,脉象必然数而无力,以四物汤养血为主;气虚的人,脉象必然缓而无力,以四君子汤补气为主;有痰的人,脉象必然滑数,以二陈汤为主;有热的人,脉象必然数而有力,以解毒汤主之。
凡是噎膈翻胃,全部使用二陈汤加入姜汁、竹沥、童便、韭汁等作为主要治疗手段。
如果胸中感觉有热闷感,加入土炒黄芩、黄连、瓜蒌仁、桔梗等。
如果是血虚瘦弱的人,合用四物汤,少量加入杏仁泥、红花、童便、韭汁等,仍然不可缺少。
如果是朝食暮吐,暮食朝吐,或者食下不久即吐的情况,这是胃能够容纳但脾不能传送的表现。或者是大小肠闭结不通,食物返而上奔,加入酒蒸大黄以润通。脾不磨化者,加入神曲、麦芽等,以助其衰弱的运化之火。
如果是气虚肥胖之人患膈噎,合用四君子汤,也必须加入竹沥、姜汁作为要药。
如果是七情郁结,形成气噎的,加入香附、抚芎、木香、槟榔、瓜蒌仁、砂仁等。
如果是饮酒的人,加入砂糖、驴尿内服。
如果是膈噎,大便燥结,使用大黄,这是急则治其标的药剂。仍需用四物汤,加入童便、姜汁,多饮牛羊乳为上策。但不可以用人乳代替,因为人乳内有饮食烹饪的火气。
如果是气血两虚,则口中多出泡沫。只要见到泡沫大量涌出,必定死亡。粪便像羊屎一样干硬的不治,这是因为大肠无血。年龄超过五十岁的不治。
中年妇女患翻胃,用四物汤,加入带白皮的陈皮、留尖的杏仁、生甘草、酒制红花浓煎,加入驴尿,以防生虫,服用几帖即可痊愈。
治疗翻胃噎膎,用螃蟹洗净,放入水中高四指深,将一小酒盏香油倒入水中,用两根手指捻白面撒在水面上,蟹涎就会流出。第二天去掉螃蟹,留下水分晒干后的涎末,每次服用五分,用淡烧酒送下。
方剂
主方 治疗一切翻胃噎膎,是总的核心药物。
韭汁(二两) 牛乳(一盏) 生姜(半两,取汁) 竹沥(半盏) 童便(一盏)
以上五味混合均匀,加热后顿服。或者加入煎剂中一起煎煮,效果尤为极好。
顺气和中汤(云林制) 治疗呕吐翻胃,嘈杂吞酸。
半夏(制,六分) 白茯苓(七分) 白术(土炒,八分) 广皮(盐水浸,炒,一钱)
枳实(麸炒,五分) 甘草(炙,二分) 香附(醋炒,一钱) 山栀(姜汁炒黑,一钱) 神
曲(炒,六分) 砂仁(炒,三分) 黄连(姜汁浸,晒干,以猪胆汁拌炒,六分)
以上锉成一剂,生姜三片,长流水注入娇泥中搅拌,澄清后取水一钟,煎至七分,加入竹沥、童便、姜汁,不拘时间,细细温服。心胃痛,加姜汁三匙。如气虚,加人参、黄芪各八分。如血虚,加当归七分,川芎五分。如恼怒或气机不畅,加乌药五分、木香三分。如胸膈饱闷,加炒萝卜子六分。如心下嘈杂吞酸,加吴茱萸四分,加倍黄连、白术。如呕吐不止,加藿香七分。如大便闭结,加苏子、麻仁、桃仁、杏仁,都研成泥状,一钱,再用白蜜,时时服用。
安中调气丸(云林制) 治疗一切翻胃痰膎之证。
广皮(二两) 半夏(姜制,一两) 白茯神(一两) 白术(土炒,二两) 枳实(麸
炒,一两) 苏子(炒,六钱) 川芎(五钱) 当归(酒洗,五钱) 白芍药(盐酒洗,炒,
八钱) 木香(一钱) 甘草(炙,三钱) 香附(三两,长流水浸三日,洗净炒,黄色) 神
曲(炒,一两) 黄连(姜汁浸,晒干,猪胆汁拌炒,一两) 白豆蔻(五钱,萝卜子炒,五钱)
以上为细末,用竹沥、姜汁打神曲糊做成丸,如绿豆大。每次服用八十丸,不拘时间,白开水送下,清米汤也可以。
四七调气汤(西园公方) 治疗七情四气,以致膈噎翻胃。
紫苏(一钱五分) 厚朴(姜汁炒,一钱五分) 茯苓(一钱五分) 半夏(一钱五分)
枳实(炒,一钱半) 砂仁(一钱五分) 苏子(炒,一钱五分) 陈皮(一钱五分) 甘草(五分)
以上锉碎,生姜三片,水煎服。之后服用加味保和丸,加人参一两,砂仁二两,木香二两,服用以收功。
四子调中汤〔批〕(按此方治翻胃专因气者) 治疗翻胃,或大小便闭,及痰气壅盛。
青皮(麸炒,五分) 陈皮(五分) 枳实(麸炒,一钱) 香附(炒,一钱) 黄连(姜
汁炒,七分) 半夏(制,二钱) 瓜蒌仁(炒,一钱) 苏子(炒,一钱) 沉香(五分)
茯苓(五分) 桃仁(去皮尖,一钱半) 白芥子(炒,一钱) 木通(五分) 芒硝(五分)
以上锉成一剂,生姜五片,水煎稍热服。
神奇散(方外人传)〔批〕(按此方治翻胃血虚有火者) 治疗噎食翻胃,三阳枯竭。
当归(一钱) 川芎(七分) 白芍药(酒炒,一钱) 生地黄(二钱) 陈皮(八分)
砂仁(七分) 半夏(姜制,八分) 白茯苓(一钱) 白术(土炒) 香附(醋炒,一钱) 枳
实(炒,一钱) 乌梅(三个) 藿香(一钱) 赤茯苓(一钱) 槟榔(一钱) 木通(一钱)
猪苓(一钱) 黄芩(炒,一钱) 黄柏(酒炒,一钱) 知母(人乳拌炒,一钱) 赤芍药
(一钱) 天门冬(去心,一钱) 麦门冬(去心,一钱) 甘草(八分)
以上锉成一剂,水二钟,煎至一钟,加入童便一盏,服用。
吕纯阳降笔传治翻胃方
藿香(一钱) 陈皮(一钱) 半夏(八分) 赤茯苓(一钱) 人参(一钱) 白豆蔻
(一钱) 苏子(炒,一钱) 厚朴(制,八分) 槟榔(八分) 枇杷叶(蜜炙,一钱) 白芥
子(炒,八分) 沉香(一钱) 良姜(三分) 官桂(二分) 丁皮(二分) 杵头糠(一撮)
以上锉成一剂,生姜三片,枣一枚,水二盏,煎至八分服。
加味六君子汤 治疗脾胃大虚,以致膈噎不食。
六君子汤加炮干姜、白豆蔻、黄连、制吴茱萸。
回生养胃丹〔批〕(按此方治翻胃气虚有寒者) 治疗真元虚损,心胃不交,
精神耗散。脾脏受湿,饮食不纳,五味不成津液,反成痰涎,聚于中
脘,不能传道,以致大肠燥涩,小便反多而赤。或时呕吐酸水,久成翻胃结肠之证。
苍术(米泔水浸三日,洗净晒干,再换浸三日,四两) 莲肉(酒浸一宿,四两)
雄猪肚(一个,壁土揉擦洗净入苍术、莲肉在内,以线缝紧,用好酒煮烂,取入石臼内
捣如泥,捻作小饼,烘干加后药) 南星(四两,细切,姜汁浸一宿,以伏龙肝同炒,去
伏龙肝用,或用黄土亦可) 半夏(四两,泡,晒干细切,好醋浸七日,蒸熟) 橘红(四
两,以灶心土炒,去土用) 粟米(四两,姜汁浸,蒸,焙) 人参(一两) 白术(一两
)白茯苓(一两) 厚朴(姜汁炒,一两) 蓬术(一两,醋炒) 荜澄茄(一两) 砂仁(一两)
三棱(一两,醋炒) 白豆蔻(一两) 谷芽(炒,一两) 麦芽(炒,一两) 甘草(一两
)丁香(五钱) 木香(五钱) 沉香(五钱)
以上为末,稀面糊为丸,如梧桐子大。每次服用一百丸,空腹时,陈米汤送下。
加味保和丸〔批〕(按此方治翻胃有热者) 治疗实热翻胃。
保和丸(三钱,方见伤食) 加姜汁浸炒黄连三钱、山楂肉三钱,共为
末,米糊为丸,如麻子大。每次服用六十丸,煎人参竹沥汤送下。
九仙夺命丹(秘方) 治疗翻胃痰涎壅盛。
南星(姜制,三钱) 半夏(姜制,五钱) 枯明矾(五钱) 枳壳(麸炒,一两) 厚
朴(姜制,五钱) 人参(三钱) 木香(四钱) 豆豉(洗,一两) 甘草(三钱) 加阿魏
(三钱) 糖球子(五钱)
以上为末,老米打糊为饼如钱大,瓦上焙干,晴夜露过。每次服用一
饼,细嚼,以姜煎平胃散送下。
沉香降气丹(长葛李大尹传方)〔批〕(按此方治翻胃腹中积块者) 治疗翻胃腹中有积块。
黑牵牛(取头末,三两) 大黄(一两,酒蒸) 槟榔(一两) 当归(一两,酒浸)
良姜(三钱) 苍术(一两) 青皮(炒,一两) 陈皮(五钱) 乌药(一两) 砂仁(五钱)
枳壳(麸炒,一两) 枳实(麸炒,五钱) 香附(一两,炒) 沉香(三钱) 三棱(三钱,火
煨) 半夏(制,五钱) 木香(三钱) 莪术(三钱,火煨) 黄连(一两,姜汁炒) 黄芩(一两,酒炒)
以上为末,酒糊为丸桐子大。每次服用六七十丸,淡姜汤送下。
木香顺气丸(俞九河传方)〔批〕(按此方治翻胃大便闭结者) 治疗翻胃大便闭结者。
沉香(五钱) 木香(三钱) 当归(一两,酒浸) 白茯苓(一两) 山药(一两) 郁
李仁(二两) 槟榔(二两) 菟丝子(一两,酒制) 牛膝(二两,酒浸) 枳壳(一两,面
炒) 独活(一两) 防风(一两) 火麻仁(二两) 大黄(酒蒸,五钱)
以上为末,炼蜜为丸如梧子大。每次服用二十五丸,白滚汤下。
定生丹(秘方)〔批〕(按此方治定翻胃之生死者) 治疗噎膈翻胃。
雄黄(三钱) 朱砂(三钱) 阿魏(五分,箬焙) 砂(五分) 乳香(三钱) 半夏
(三钱) 木香(三钱) 沉香(一钱) 肉豆蔻(三钱) 绿豆(四十粒) 乌梅(四十个)
百草霜(三钱,为衣)
以上为末,将乌梅以热汤泡令软,剥去核,研极烂,入药捣为丸,如弹子大,百草霜为衣,阴干。每次
用一粒,含化咽下,以姜汤漱口,复以陈麦饼火烧熟,细嚼压之。含药即燃官香一炷,如香尽
药未化者,难治;药先化香未尽者,可愈。按此方用之以定吉凶生死者。
养血助胃丸(云林制)〔批〕(按此方治翻胃收功保后之剂) 治疗呕吐翻胃,愈
后用此养元气,健脾胃,生血脉,调荣卫,清郁气,收功保后。
当归(酒洗,一两) 川芎(一两) 白芍(盐酒炒,一两二钱) 熟地黄(姜汁浸炒,
八钱) 人参(五钱) 白术(土炒,一两三钱) 白茯苓(六钱) 甘草(炙,三钱) 山药
(炒,一两) 莲肉(去皮心,一两) 扁豆(姜汁炒,六钱)
以上为末,姜打神曲糊为丸如梧桐子大。每次服用六七十丸,空腹白滚水下。
Symptoms
Nausea refers to a state where there is no sound and no vomitus, but the patient feels an urge to vomit without being able to do so. Although called "nausea," this is not a disease of the Heart Meridian (Heart Channel). The pathology lies above the stomach region, caused by deficiency, heat, cold, food stagnation, or phlegm.
Treatment Principles
The treatment principles are: tonify for deficiency, clear for heat, warm for cold, and resolve/digest for food stagnation and phlegm. Ginger and ginger juice should be used in all these cases as adjuvant herbs, combined with other medications according to specific symptoms, yielding the fastest effect.
Formulas
Er Chen Tang (Two-Cured Decoction; see Phlegm Section) added with Huangqin (Scutellariae Radix, 黄芩) and Lian (Coptidis Rhizoma, 黄连) stir-fried with ginger juice, plus Zhizi (Gardeniae Fructus, 栀子), treats nausea due to stomach heat.
Da Banxia Tang (Large Pinellia Decoction) (i.e., Er Chen Tang minus Gancao [Glycyrrhizae Radix et Rhizoma, 甘草], added with Shengjiang [Zingiberis Rhizoma Recens, 生姜]), treats nausea due to stomach cold.
Xiao Banxia Fuling Tang (Small Pinellia and Poria Decoction) (i.e., Da Banxia Tang minus Chenpi [Citri Reticulatae Pericarpium, 陈皮], with doubled Shengjiang [Zingiberis Rhizoma Recens, 生姜]), treats the sensation of uneasiness in the heart/chest with an urge to vomit.
Dao Tan Tang (Phlegm-Resolving Decoction) (i.e., Er Chen Tang added with Nanxing [Arisaematis Rhizoma Preparatum, 天南星] and Zhike [Aurantii Fructus Immaturus, 枳壳]), added with Zhuru (Bambusae Caulis in Taenia, 竹茹), Sharen (Amomi Fructus, 砂仁), and Huanglian (Coptidis Rhizoma, 黄连) stir-fried with ginger, treats vomiting due to phlegm-heat and nausea with excessive rebellious qi.
Pulse Diagnosis
A floating and moderate pulse indicates survival (good prognosis); a deep and choppy pulse indicates death (poor prognosis). A choppy and small pulse indicates blood deficiency; a large and weak pulse indicates qi deficiency.
Symptoms
Fanwei (Reversal Stomach/Regurgitation) refers to eating in the morning and vomiting in the evening, eating in the evening and vomiting in the morning, or vomiting immediately after eating. Ge Ye (Diaphragmatic Obstruction) refers to the Five Ge (Obstructions) and Five Ye (Choking). The Five Ge are caused by worry, anger, cold, heat, and qi; the Five Ye are caused by worry, thought, fatigue, food, and qi. "Ge" occurs between the Heart and Spleen, where upper and lower pathways are blocked, resembling a rejection or obstruction. Sometimes it knots at the throat, causing a sensation of obstruction, unable to spit out or swallow down, resulting from qi stagnation and phlegm binding. Over time, it gradually hinders diet, forming "Ge." "Ye" occurs during eating when qi suddenly blocks, preventing food from going down, forming "Ye." Although Fanwei, Ge, and Ye have different names, their underlying pathology is the same. The *Neijing* states: "When the Three Yangs knot, it is called Ge." The Three Yangs refer here to the Large Intestine and Bladder (Note: Textual interpretation follows original). Knotting refers to heat accumulation. Heat accumulation in the Small Intestine dries the blood vessels; heat accumulation in the Large Intestine prevents defecation; heat accumulation in the Bladder depletes body fluids. Once the Three Yangs are knotted, both anterior and posterior orifices become blocked. Since the lower pathway is blocked, qi rebels upward, causing difficulty swallowing and regurgitation of food. This is due to Yang fire failing to descend and instead rising. Thus, the classics say: "Where Shaoyang (Lesser Yang) qi arrives, there is vomiting, gurgling, and inability to eat," which clarifies this principle. Zhu Danxi said: "At the beginning of qi disorders, the signs are very subtle." It may be due to slight dietary indiscretion; or external exposure to wind and rain with internal injury from the Seven Emotions; or overly rich flavors that excessively assist Yang qi, accumulating into diaphragmatic heat; or a robust constitution with tight pores and no sweating; or an irritable temperament causing Ministerial Fire to flare up, leading to failure of fluid circulation and interference between clear and turbid qi. Qi disorders may manifest as fullness or pain, loss of appetite, belching with sour regurgitation, or gastric discomfort with retching. If physicians do not seek the root cause and assume it is cold, they hastily administer acrid, aromatic, drying, and hot agents. Temporary relief leads them to believe it is a miraculous formula. However, if rich foods remain uncontrolled and emotions fluctuate, the old disease is temporarily suppressed but turbid fluids easily re-accumulate. After half a month or a month, previous symptoms recur. Such progression transforms qi stagnation into mass formation, and mass formation into phlegm-fluid retention, giving rise to phlegm, fluid retention, and sour regurgitation. Before encountering a skilled physician, if drying agents are administered again, phlegm binds with blood stasis, forming nests/cysts. This sequentially produces symptoms of fullness, pain, vomiting, Ge-Ye (diaphragmatic obstruction), and Fanwei. Patients may still consider it deficiency-cold accumulation, believing ordinary herbs cannot treat it, and instead use Wutou (Aconiti Lateralis Radix Preparata, 乌头) and Fuzi (Aconiti Lateralis Radix Preparata, 附子) assisting alchemical pills, focusing on ingestion. Over time, blood and fluids are depleted, and the stomach lining becomes dry and shriveled. If the dryness is in the upper part, near the throat, liquids can pass, but food is difficult to enter. Occasionally entering, intake is small, termed "Ye." If the dryness is in the lower part, near the stomach, food can go down but fails to fully enter the stomach, returning after a long time, termed "Ge," also called "Fanwei."
Treatment Principles
Treatment should nourish blood and generate fluids, clear phlegm and descend fire, moisten dryness and tonify the Spleen, suppress Liver and relieve depression, so that pathogenic factors can be subdued and Stomach qi opens. Nevertheless, recovery depends on the patient's self-care. I observe that Zhang Jifeng said: "Ye is a disorder of the spirit/mind; only introspection and self-nourishment can cure it." This statement deeply hits the mark of the condition.
*Gouxuan* states: Fanwei roughly has four types: Blood syndrome, Qi deficiency, Phlegm, and Heat. For blood deficiency, the pulse is rapid and forceless; treat primarily with Siwu Tang (Four Substances Decoction) to nourish blood. For qi deficiency, the pulse is slow and forceless; treat primarily with Sijunzi Tang (Four Gentlemen Decoction) to tonify qi. For phlegm, the pulse is slippery and rapid; treat primarily with Er Chen Tang (Two-Cured Decoction). For heat, the pulse is rapid and forceful; treat primarily with Jiedu Tang (Detoxification Decoction).
For all Ge-Ye and Fanwei, Er Chen Tang (Two-Cured Decoction) added with Jiangzhi (Ginger Juice), Zhuli (Bamboo Sap), Tongbian (Child's Urine), and Jiuzhi (Chinese Chive Juice) serves as the main treatment.
If there is a sensation of heat and oppression in the chest, add Tu Chao Huangqin (Scutellariae Radix, 黄芩 stir-fried with earth), Huanglian (Coptidis Rhizoma, 黄连), Gualouren (Trichosanthis Semen, 瓜蒌仁), and Jiegeng (Platycodonis Radix, 桔梗).
For patients with blood deficiency and emaciation, combine with Siwu Tang (Four Substances Decoction), adding small amounts of Xingrenni (Apricot Seed Paste, 杏仁泥), Honghua (Carthami Flos, 红花), Tongbian (Child's Urine, 童便), and Jiuzhi (Chinese Chive Juice, 韭汁), which must not be omitted.
For morning eating/evening vomiting or immediate post-prandial vomiting, this indicates the Stomach can receive but the Spleen cannot transport. Or it is due to blockage in the Large and Small Intestines causing food to rebel upward; add Jiu Zheng Dahuang (Rhei Radix et Rhizoma, 大黄 steamed with wine) to moisten and unblock. If the Spleen fails to digest, add Shenqu (Massa Medicata Fermentata, 神曲) and Maiya (Hordei Fructus Germinatus, 麦芽) to assist its declining digestive fire.
For obese patients with Qi deficiency suffering from Ge-Ye, combine with Sijunzi Tang (Four Gentlemen Decoction), and adding Zhuli (Bamboo Sap, 竹沥) and Jiangzhi (Ginger Juice, 姜汁) is essential.
For Ge-Ye caused by emotional depression forming Qi-Ye, add Xiangfu (Cyperi Rhizoma, 香附), Fuxiong (Ligustici Chuanxiong Rhizoma, 抚芎), Muxiang (Aucklandiae Radix, 木香), Binglang (Arecae Semen, 槟榔), Gualouren (Trichosanthis Semen, 瓜蒌仁), and Sharen (Amomi Fructus, 砂仁).
For drinkers, add Baitang (White Sugar, 砂糖) and Lv Niao (Donkey Urine, 驴尿) for oral administration.
For Ge-Ye with dry stool constipation, use Dahuang (Rhei Radix et Rhizoma, 大黄); this is a treatment for acute symptoms (treating the branch). Continue using Siwu Tang (Four Substances Decoction, 四物汤) added with Tongbian (Child's Urine, 童便) and Jiangzhi (Ginger Juice, 姜汁); drinking abundant cow or sheep milk is the best strategy. Human milk should not be used because it contains the "fire" of cooking and digestion.
For dual Qi and Blood deficiency with excessive salivation/phlegm foam in the mouth, massive foaming indicates certain death. Stool like sheep pellets is incurable due to lack of blood in the Large Intestine. Patients over fifty years old are incurable.
For middle-aged women with Fanwei, use Siwu Tang (Four Substances Decoction, 四物汤) added with Chenpi (Citri Reticulatae Pericarpium, 陈皮) retaining the white pith, Xingren (Armeniacae Semen Amarum, 杏仁) retaining the tips, Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma, 生甘草), and Jiu Honghua (Carthami Flos, 红花 soaked in wine) decocted strongly, added with Lv Niao (Donkey Urine, 驴尿) to prevent parasitic worms; several doses will cure it.
To treat Fanwei and Ge-Ye, wash a crab clean, place it in water four fingers deep, pour a small wine cup of Sesame Oil (Xiangyou, 香油) into the water, and sprinkle flour kneaded with two fingers onto the water surface; crab saliva will exude. Remove the crab the next day, dry the remaining liquid until the saliva becomes powder. Take 5 fen each time, washed down with light rice wine.
Formulas
Main Formula: Treats all Fanwei and Ge-Ye; it is the general key medication.
Jiuzhi (Chinese Chive Juice, 韭汁, 2 liang) Niurui (Cow Milk, 牛乳, 1 zhan) Shengjiang (Fresh Ginger, 生姜, 0.5 liang, juice extracted) Zhuli (Bamboo Sap, 竹沥, 0.5 zhan) Tongbian (Child's Urine, 童便, 1 zhan)
Mix the five ingredients evenly, warm thoroughly, and take in one dose. Alternatively, add to decoctions for even greater efficacy.
Shunqi Hezhong Tang (Cloud Forest Preparation): Treats vomiting, Fanwei, gastric discomfort, and acid regurgitation.
Banxia (Prepared Pinellia, 半夏, 6 fen) Baifuling (White Poria, 白茯苓, 7 fen) Baizhu (Earth-stir-fried Atractylodes Macrocephala Rhizome, 白术, 8 fen) Guangpi (Salt-water soaked and stir-fried Citrus Peel, 广皮, 1 qian) Zhishi (Bran-stir-fried Immature Bitter Orange, 枳实, 5 fen) Gancao (Honey-roasted Licorice, 甘草, 2 fen) Xiangfu (Vinegar-stir-fried Cyperi Rhizoma, 香附, 1 qian) Shanzhi (Blackened with Ginger Juice Stir-fry Gardenia, 山栀, 1 qian) Shenqu (Stir-fried Medicated Leaven, 神曲, 6 fen) Sharen (Stir-fried Amomi Fructus, 砂仁, 3 fen) Huanglian (Soaked in Ginger Juice, dried, stir-fried with Pig Bile Coptidis Rhizoma, 黄连, 6 fen)
Decoct one dose with 3 slices of Shengjiang (Fresh Ginger, 生姜) in clear flowing water mixed with Jiaoni (soft mud/clay), clarified. Use 1 zhong of water, decoct to 0.7 zhong. Add Zhuli (Bamboo Sap, 竹沥), Tongbian (Child's Urine, 童便), and Jiangzhi (Ginger Juice, 姜汁). Take warm slowly at any time. For Heart/Stomach pain, add 3 spoons of Jiangzhi (Ginger Juice, 姜汁). For Qi deficiency, add Renshen (Ginseng Radix et Rhizoma, 人参) and Huangqi (Astragali Radix, 黄芪) 8 fen each. For Blood deficiency, add Danggui (Angelicae Sinensis Radix, 当归) 7 fen and Chuanxiong (Ligustici Chuanxiong Rhizoma, 川芎) 5 fen. For anger or constrained Qi, add Wuyao (Linderae Radix, 乌药) 5 fen and Muxiang (Aucklandiae Radix, 木香) 3 fen. For chest/fullness oppression, add stir-fried Luobozhi (Radish Seed, 萝卜子) 6 fen. For epigastric discomfort and acid regurgitation, add Wuzhuyu (Evodiae Fructus, 吴茱萸) 4 fen, doubling Huanglian (Coptidis Rhizoma, 黄连) and Baizhu (Atractylodes Macrocephala Rhizome, 白术). For persistent vomiting, add Huoxiang (Agastaches Herba, 藿香) 7 fen. For constipation, add Suzi (Perillae Fructus, 苏子), Hama Ren (Hemp Seed, 麻仁), Taoren (Persicae Semen, 桃仁), and Xingren (Armeniacae Semen Amarum, 杏仁), all ground to paste, 1 qian total, taken frequently with Bai Mi (White Honey, 白蜜).
Anzhong Tiaoqi Wan (Cloud Forest Preparation): Treats all Fanwei and Phlegm-Ge syndromes.
Guangpi (Citrus Peel, 广皮, 2 liang) Banxia (Ginger-prepared Pinellia, 半夏, 1 liang) Baifushen (White Poria with Wood, 白茯神, 1 liang) Baizhu (Earth-stir-fried Atractylodes Macrocephala Rhizome, 白术, 2 liang) Zhishi (Bran-stir-fried Immature Bitter Orange, 枳实, 1 liang) Suzi (Stir-fried Perilla Fruit, 苏子, 6 qian) Chuanxiong (Ligustici Chuanxiong Rhizoma, 川芎, 5 qian) Danggui (Wine-washed Angelicae Sinensis Radix, 当归, 5 qian) Baishaoyao (Salt-and-wine washed, stir-fried White Peony Root, 白芍药, 8 qian) Muxiang (Aucklandiae Radix, 木香, 1 qian) Gancao (Honey-roasted Licorice, 甘草, 3 qian) Xiangfu (Soaked 3 days in clear water, washed, stir-fried to yellow Cyperi Rhizoma, 香附, 3 liang) Shenqu (Stir-fried Medicated Leaven, 神曲, 1 liang) Huanglian (Soaked in Ginger Juice, dried, stir-fried with Pig Bile Coptidis Rhizoma, 黄连, 1 liang) Baidoukou (Stir-fried with Radish Seed White Cardamom, 白豆蔻, 5 qian + 5 qian radish seed)
Grind to fine powder. Make pills using Zhuli (Bamboo Sap, 竹沥) and Jiangzhi (Ginger Juice, 姜汁) with Shenqu paste, size of mung beans. Take 80 pills at any time, washed down with plain water or clear rice soup.
Siqi Tiaoqi Tang (West Garden Duke's Formula): Treats Ge-Ye and Fanwei caused by Seven Emotions and Four Qi pathogens.
Zisu (Perillae Folium, 紫苏, 1.5 qian) Houpo (Ginger-juice stir-fried Magnolia Bark, 厚朴, 1.5 qian) Fuling (Poria, 茯苓, 1.5 qian) Banxia (Pinellia, 半夏, 1.5 qian) Zhishi (Stir-fried Immature Bitter Orange, 枳实, 1.5 qian) Sharen (Amomi Fructus, 砂仁, 1.5 qian) Suzi (Stir-fried Perilla Fruit, 苏子, 1.5 qian) Chenpi (Citri Reticulatae Pericarpium, 陈皮, 1.5 qian) Gancao (Licorice, 甘草, 5 fen)
Decoct with 3 slices of Shengjiang (Fresh Ginger, 生姜) in water. Afterwards, take Jiawei Baohe Wan (Modified Harmony-Preserving Pill) added with Renshen (Ginseng Radix et Rhizoma, 人参, 1 liang), Sharen (Amomi Fructus, 砂仁, 2 liang), and Muxiang (Aucklandiae Radix, 木香, 2 liang) to conclude treatment.
Sizi Tiaozhong Tang [Commentary: For Fanwei specifically due to Qi]: Treats Fanwei, constipation of both bowels, and excessive Phlegm-Qi congestion.
Qingpi (Bran-stir-fried Green Tangerine Peel, 青皮, 5 fen) Chenpi (Citri Reticulatae Pericarpium, 陈皮, 5 fen) Zhishi (Bran-stir-fried Immature Bitter Orange, 枳实, 1 qian) Xiangfu (Stir-fried Cyperi Rhizoma, 香附, 1 qian) Huanglian (Ginger-juice stir-fried Coptidis Rhizoma, 黄连, 7 fen) Banxia (Prepared Pinellia, 半夏, 2 qian) Gualouren (Stir-fried Trichosanthes Seed, 瓜蒌仁, 1 qian) Suzi (Stir-fried Perilla Fruit, 苏子, 1 qian) Chenxiang (Aquilaria Wood, 沉香, 5 fen) Fuling (Poria, 茯苓, 5 fen) Taoren (De-skinned and de-seeded Peach Kernel, 桃仁, 1.5 qian) Baijiezi (Stir-fried White Mustard Seed, 白芥子, 1 qian) Mutong (Akebia Stem, 木通, 5 fen) Mangxiao (Mirabilite, 芒硝, 5 fen)
Decoct one dose with 5 slices of Shengjiang (Fresh Ginger, 生姜) in water, take slightly warm.
Shenqi San (Transmitted by Outsider) [Commentary: For Fanwei with Blood Deficiency and Fire]: Treats Ge-food Fanwei and depletion of Three Yangs.
Danggui (Angelicae Sinensis Radix, 当归, 1 qian) Chuanxiong (Ligustici Chuanxiong Rhizoma, 川芎, 7 fen) Baishaoyao (Wine-stir-fried White Peony Root, 白芍药, 1 qian) Shengdihuang (Raw Rehmannia Root, 生地黄, 2 qian) Chenpi (Citri Reticulatae Pericarpium, 陈皮, 8 fen) Sharen (Amomi Fructus, 砂仁, 7 fen) Banxia (Ginger-prepared Pinellia, 半夏, 8 fen) Baifuling (White Poria, 白茯苓, 1 qian) Baizhu (Earth-stir-fried Atractylodes Macrocephala Rhizome, 白术) Xiangfu (Vinegar-stir-fried Cyperi Rhizoma, 香附, 1 qian) Zhishi (Stir-fried Immature Bitter Orange, 枳实, 1 qian) Wumei (Mume Fruit, 乌梅, 3 pieces) Huoxiang (Agastaches Herba, 藿香, 1 qian) Chifuling (Red Poria, 赤茯苓, 1 qian) Binglang (Arecae Semen, 槟榔, 1 qian) Mutong (Akebia Stem, 木通, 1 qian) Zhuling (Polyporus, 猪苓, 1 qian) Huangqin (Stir-fried Scutellariae Radix, 黄芩, 1 qian) Huangbai (Wine-stir-fried Phellodendri Cortex, 黄柏, 1 qian) Zhimu (Human-milk stir-fried Anemarrhenae Rhizoma, 知母, 1 qian) Chishaoyao (Red Peony Root, 赤芍药, 1 qian) Tianmendong (Asparagi Radix, 天门冬, 1 qian) Maidong (Ophiopogonis Radix, 麦门冬, 1 qian) Gancao (Licorice, 甘草, 8 fen)
Decoct one dose in 2 zhongs of water to 1 zhong. Add 1 zhan of Tongbian (Child's Urine, 童便) and take.
Lu Chunyang's Spirit-Writing Formula for Fanwei
Huoxiang (Agastaches Herba, 藿香, 1 qian) Chenpi (Citri Reticulatae Pericarpium, 陈皮, 1 qian) Banxia (Pinellia, 半夏, 8 fen) Chifuling (Red Poria, 赤茯苓, 1 qian) Renshen (Ginseng Radix et Rhizoma, 人参, 1 qian) Baidoukou (White Cardamom, 白豆蔻, 1 qian) Suzi (Stir-fried Perilla Fruit, 苏子, 1 qian) Houpo (Prepared Magnolia Bark, 厚朴, 8 fen) Binglang (Arecae Semen, 槟榔, 8 fen) Pipaye (Honey-roasted Loquat Leaf, 枇杷叶, 1 qian) Baijiezi (Stir-fried White Mustard Seed, 白芥子, 8 fen) Chenxiang (Aquilaria Wood, 沉香, 1 qian) Liangjiang (Galangal Rhizome, 良姜, 3 fen) Guangui (Cinnamon Twig, 官桂, 2 fen) Dingpi (Syzygium Aromaticum Bark, 丁皮, 2 fen) Chutoukuang (Rice Husk, 杵头糠, 1 pinch)
Decoct one dose with 3 slices of Shengjiang (Fresh Ginger, 生姜), 1 Jujube (Ziziphus Jujuba Fruit, 枣), and 2 zhans of water to 0.8 zhan.
Jiawei Liujunzi Tang (Modified Six-Gentlemen Decoction): Treats severe Spleen-Stomach deficiency causing Ge-Ye and anorexia.
Liujunzi Tang (Six-Gentlemen Decoction, 六君子汤) added with Paoganjiang (Roasted Dried Ginger, 炮干姜), Baidoukou (White Cardamom, 白豆蔻), Huanglian (Coptidis Rhizoma, 黄连), and Zhi Wuzhuyu (Processed Evodiae Fructus, 制吴茱萸).
Huisheng Yangwei Dan [Commentary: For Fanwei with Qi Deficiency and Cold]: Treats True Yuan deficiency, Heart-Stomach disconnect, and dissipation of Spirit. Dampness in the Spleen causes failure to accept food; the five flavors fail to transform into fluids, instead becoming phlegm-saliva, gathering in Zhongwan, failing to transmit, leading to dry Large Intestine and frequent red urination. Occasional vomiting of sour water eventually forms Fanwei and Colon Syndrome.
Cangzhu (Soaked 3 days in rice washing water, washed, dried, soaked again 3 days, 4 liang) Lianrou (Lotus Seed, soaked overnight in wine, 4 liang) Xiongzhu Du (Male Pig Stomach, 1 piece, rubbed with wall earth, washed, filled with Cangzhu and Lianrou, sewn tightly, boiled rotten in good wine, removed, pounded in stone mortar to paste, formed into small cakes, dried, then add following herbs) Nanxing (Arisaematis Rhizoma Preparatum, 天南星, 4 liang, finely cut, soaked overnight in Ginger Juice, stir-fried with Fulonggan [Dragon Sitting Earth, 伏龙肝], discard Fulonggan, or use Yellow Earth) Banxia (Pinellia, 4 liang, soaked, dried, finely cut, soaked 7 days in good vinegar, steamed) Juhong (Tangerine Red Peel, 橘红, 4 liang, stir-fried with Hearth Soil [Zaoxin Tu, 灶心土], discard soil) Sumi (Millet, 4 liang, soaked in Ginger Juice, steamed, baked) Renshen (Ginseng Radix et Rhizoma, 人参, 1 liang) Baizhu (Atractylodes Macrocephala Rhizome, 白术, 1 liang) Baifuling (White Poria, 白茯苓, 1 liang) Houpo (Ginger-juice stir-fried Magnolia Bark, 厚朴, 1 liang) Pengzhu (Curcuma Zedoaria Rhizome, 蓬术, 1 liang, vinegar-stir-fried) Bichengqie (Long Pepper Fruit, 荜澄茄, 1 liang) Sharen (Amomi Fructus, 砂仁, 1 liang) Sanleng (Sparganii Rhizoma, 三棱, 1 liang, vinegar-stir-fried) Baidoukou (White Cardamom, 白豆蔻, 1 liang) Guya (Sprouted Millet, 谷芽, 1 liang, stir-fried) Maiya (Sprouted Barley, 麦芽, 1 liang, stir-fried) Gancao (Licorice, 甘草, 1 liang) Dingxiang (Clove, 丁香, 5 qian) Muxiang (Aucklandiae Radix, 木香, 5 qian) Chenxiang (Aquilaria Wood, 沉香, 5 qian)
Grind to powder. Make pills with thin flour paste, size of Sophora seeds. Take 100 pills on an empty stomach, washed down with aged rice soup.
Jiawei Baohe Wan [Commentary: For Fanwei with Heat]: Treats Excess-Heat Fanwei.
Baohe Wan (Harmony-Preserving Pill, 保和丸, 3 qian; formula in Food Injury section) added with Huanglian (Coptidis Rhizoma, 黄连) soaked in Ginger Juice and stir-fried (3 qian) and Shanzha (Crataegi Fructus, 山楂肉, 3 qian). Grind to powder, make pills with rice paste, size of sesame seeds. Take 60 pills, washed down with Ginseng and Bamboo Sap Soup.
Jiuxian Duoming Dan (Secret Formula): Treats Fanwei with excessive Phlegm-Saliva congestion.
Nanxing (Ginger-prepared Arisaema, 南星, 3 qian) Banxia (Ginger-prepared Pinellia, 半夏, 5 qian) Kumingfan (Calcined Alum, 枯明矾, 5 qian) Zhike (Bran-stir-fried Aurantii Fructus Immaturus, 枳壳, 1 liang) Houpo (Ginger-prepared Magnolia Bark, 厚朴, 5 qian) Renshen (Ginseng Radix et Rhizoma, 人参, 3 qian) Muxiang (Aucklandiae Radix, 木香, 4 qian) Douchi (Washed Fermented Soybean, 豆豉, 1 liang) Gancao (Licorice, 甘草, 3 qian) Ajiao (Donkey-hide Gelatin? Note: Text says Awei Asafoetida, 阿魏, 3 qian) Tangqiuzi (Sugar Ball Seed? Likely a specific ingredient, 糖球子, 5 qian)
Grind to powder. Make cakes with old rice paste, size of coins, bake on tile, expose to night dew on clear nights. Take one cake each time, chew well, washed down with Ginger-decocted Pingwei San (Peace the Stomach Powder, 平胃散).
Chenxiang Jiangqi Dan (Transmitted by Li Dayin of Changge) [Commentary: For Fanwei with Abdominal Mass]: Treats Fanwei with abdominal masses.
Hei Qianniu (Black Morning Glory Seed, head powder, 3 liang) Dahuang (Wine-steamed Rhubarb, 大黄, 1 liang) Binglang (Arecae Semen, 槟榔, 1 liang) Danggui (Wine-soaked Angelicae Sinensis Radix, 当归, 1 liang) Liangjiang (Galangal Rhizome, 良姜, 3 qian) Cangzhu (Atractylodes Rhizome, 苍术, 1 liang) Qingpi (Stir-fried Green Tangerine Peel, 青皮, 1 liang) Chenpi (Citri Reticulatae Pericarpium, 陈皮, 5 qian) Wuyao (Linderae Radix, 乌药, 1 liang) Sharen (Amomi Fructus, 砂仁, 5 qian) Zhike (Bran-stir-fried Aurantii Fructus Immaturus, 枳壳, 1 liang) Zhishi (Bran-stir-fried Immature Bitter Orange, 枳实, 5 qian) Xiangfu (Stir-fried Cyperi Rhizoma, 香附, 1 liang) Chenxiang (Aquilaria Wood, 沉香, 3 qian) Sanleng (Fire-roasted Sparganii Rhizoma, 三棱, 3 qian) Banxia (Prepared Pinellia, 半夏, 5 qian) Muxiang (Aucklandiae Radix, 木香, 3 qian) Ezhu (Fire-roasted Curcuma Longa Rhizome, 莪术, 3 qian) Huanglian (Ginger-juice stir-fried Coptidis Rhizoma, 黄连, 1 liang) Huangqin (Wine-stir-fried Scutellariae Radix, 黄芩, 1 liang)
Grind to powder. Make pills with wine paste, size of tung seeds. Take 60-70 pills, washed down with light Ginger Soup.
Muxiang Shunqi Wan (Transmitted by Yu Jiuhe) [Commentary: For Fanwei with Constipation]: Treats Fanwei with constipation.
Chenxiang (Aquilaria Wood, 沉香, 5 qian) Muxiang (Aucklandiae Radix, 木香, 3 qian) Danggui (Wine-soaked Angelicae Sinensis Radix, 当归, 1 liang) Baifuling (White Poria, 白茯苓, 1 liang) Shanyao (Dioscoreae Rhizoma, 山药, 1 liang) Yuliren (Prunus Sibirica Kernel, 郁李仁, 2 liang) Binglang (Arecae Semen, 槟榔, 2 liang) Tusizi (Wine-processed Cuscutae Semen, 菟丝子, 1 liang) Niuxi (Wine-soaked Achyranthes Root, 牛膝, 2 liang) Zhike (Flour-stir-fried Aurantii Fructus Immaturus, 枳壳, 1 liang) Duohuo (Angelicae Pubescentis Radix, 独活, 1 liang) Fangfeng (Saposhnikoviae Radix, 防风, 1 liang) Huomaren (Hemp Seed, 火麻仁, 2 liang) Dahuang (Wine-steamed Rhubarb, 大黄, 5 qian)
Grind to powder. Make pills with refined honey, size of tung seeds. Take 25 pills, washed down with boiling water.
Dingsheng Dan (Secret Formula) [Commentary: To Determine Life or Death in Fanwei]: Treats Ge-Ye Fanwei.
Xionghuang (Realgar, 雄黄, 3 qian) Zhusha (Cinnabar, 朱砂, 3 qian) Awei (Asafoetida, 阿魏, 5 fen, roasted on bamboo leaf) Sha (Borax? Text says Sha, likely Borax or similar mineral, 砂, 5 fen) Ruxiang (Frankincense, 乳香, 3 qian) Banxia (Pinellia, 半夏, 3 qian) Muxiang (Aucklandiae Radix, 木香, 3 qian) Chenxiang (Aquilaria Wood, 沉香, 1 qian) Roudoukou (Myristica Seed, 肉豆蔻, 3 qian) Lvdou (Mung Bean, 绿豆, 40 grains) Wumei (Mume Fruit, 乌梅, 40 pieces) Baicaoshuang (Soot from Chimney, 百草霜, 3 qian, for coating)
Grind to powder. Soak Wumei (Mume Fruit, 乌梅) in hot water until soft, remove pits, grind extremely fine, mix with medicine, pound into pills, size of bullet, coat with Baicaoshuang (Soot from Chimney, 百草霜), dry in shade. Use one pill each time, hold in mouth to dissolve and swallow. Rinse mouth with Ginger Soup. Then eat a well-cooked old wheat cake, chew finely to press down. While holding the medicine, burn one stick of official incense. If incense burns out before pill dissolves, difficult to treat; if pill dissolves before incense burns out, curable. This formula is used to determine auspicious/inauspicious outcomes and life/death.
Yangxue Zhuwei Wan (Cloud Forest Preparation) [Commentary: For Recovery and Maintenance after Fanwei]: Treats vomiting and Fanwei; used after recovery to nourish Original Qi, strengthen Spleen-Stomach, generate blood vessels, regulate Ying and Wei, clear stagnant Qi, and ensure lasting recovery.
Danggui (Wine-washed Angelicae Sinensis Radix, 当归, 1 liang) Chuanxiong (Ligustici Chuanxiong Rhizoma, 川芎, 1 liang) Baishao (Salt-and-wine stir-fried White Peony Root, 白芍, 1.2 liang) Shudihuang (Ginger-juice soaked and stir-fried Prepared Rehmannia Root, 熟地黄, 8 qian) Renshen (Ginseng Radix et Rhizoma, 人参, 5 qian) Baizhu (Earth-stir-fried Atractylodes Macrocephala Rhizome, 白术, 1.3 liang) Baifuling (White Poria, 白茯苓, 6 qian) Gancao (Honey-roasted Licorice, 甘草, 3 qian) Shanyao (Stir-fried Dioscoreae Rhizoma, 山药, 1 liang) Lianrou (Lotus Seed, peeled and de-hearted, 莲肉, 1 liang) Bidou (Ginger-juice stir-fried Lablab Bean, 扁豆, 6 qian)
Grind to powder. Make pills with Ginger-kneaded Shenqu paste, size of tung seeds. Take 60-70 pills on an empty stomach, washed down with boiling water.