论曰上气呕吐者,气上而不下,肺胃虚也,肺脉起于中焦。还循胃口,寒气乘于肺。则
上气喘满,升降不利,痰饮停积中焦。气动于胃。胃气逆则呕吐。
治上气呕吐。胸满喘息不利。紫苏子汤方
紫苏子 半夏(汤洗七遍去滑焙) 五味子 青橘皮(汤浸去白焙) 杏仁(汤浸去皮
尖双
仁麸炒) 桂(去粗皮各一两) 赤茯苓 甘草(炙各半两)
上八味粗捣筛,每服五钱匕,水一盏半。入姜半分切,同煎取七分,去滓温服。不拘时
候。
治肺胃有寒,上气呕吐。胸满不食,胡椒丸方
胡椒(去黑皮) 陈橘皮(汤浸去白焙) 甘草(炙锉) 紫菀(去苗土各一两) 桂
(去粗皮)
诃黎勒(煨
上一十二味,捣罗为末,炼蜜丸如梧桐子大,每服三十丸。生姜橘皮汤下,不拘时候,
日三服。
治上气食即吐逆。七气汤方
草豆蔻(去皮生用) 人参 赤茯苓(去黑皮) 白术 大腹(和生锉生用) 诃黎勒
(煨去
核各半两
上七味,粗捣筛,每服三钱匕,水一盏,煎至六分,去滓温服,不思食,入生姜煎服。
治气逆食则呕吐,半夏汤方
半夏(汤洗七遍去滑切焙) 生姜 陈橘皮(汤浸去瓤焙各二两) 桂(去粗皮一两)
上四味, 咀。分作二剂,每剂水五盏,煎取二盏,去滓分温三服,空腹饮之。
治上气痰壅呕吐,诃黎勒汤方
诃黎勒(煨去核二两) 陈橘皮(汤浸去白焙各一两) 甘草(炙锉半两) 人参(三
分)
前胡(去芦头一两) 杏仁(汤浸去皮尖双仁麸炒黄一两半) 白术 槟榔(锉) 紫苏茎
叶(各一两)
上一十一味,粗捣筛,每服五钱匕,水一盏半。入生姜五片,枣三枚劈破,同煎至七分,
去滓不计时温服。
治上气呕吐不止,芫花散方
芫花(一两醋炒) 肉豆蔻(去壳锉) 槟榔(锉各一枚)
上三味,捣罗为细散,每服一钱匕,煨葱白一寸,温酒调下。
治上气呕逆不食。半夏汤方
半夏(汤洗七遍去滑一两) 干桑叶(六两) 干姜(炮一分)
上三味,粗捣筛,每服三钱匕,生姜五片,浆水一盏,煎至六分,去滓稍热服。不计时
候。
治上气呕吐。不能下食,半夏汤方
半夏(汤洗七遍去滑焙三分) 白术 人参(一两) 桂(去粗皮) 甘草(炙锉) 陈
橘皮(汤浸去白焙
上七味,粗捣筛,每服五钱匕,水一盏半。入生姜五片,枣三枚劈破,煎至七分。去滓
温服、日三。
治上气呕吐,芥子丸方
芥子(五两)
上一味,捣罗为末,炼蜜丸梧桐子大,每服七丸,寅时井华水下。亦可作散。空腹酒服
治上气呕逆,及疏利过多,虚气上攻。压气散方
木香 人参 白茯苓(去黑皮) 藿香叶 陈橘皮(汤浸去白焙) 枳壳(去瓤麸炒) 甘
草(炙锉各
上八味,捣罗为散,每服二钱匕,煎紫苏木瓜生姜汤调,再入银盏,重汤煎五七沸,温
服。
治上气呕吐,或胸中痰饮,停积呕吐,人参散方
人参 白术(锉炒各二两) 白茯苓(去黑皮一两) 甘草(炙锉) 干姜(炮各半两)
粟米一合
上六味、捣罗为散,每服二钱匕,用竹茹生姜煎汤调下。
论述说:上气呕吐,是指气机上逆而不能下行,这是肺和胃虚弱的表现。肺脉起始于中焦,回绕经过胃的上口。寒气侵袭肺部,就会导致肺气上逆、喘促胸满,气机升降不利,痰饮停滞积聚在中焦。气动扰胃,胃气上逆就会发生呕吐。
治疗上气呕吐,伴有胸满、喘息不畅的紫苏子汤方:
紫苏子、半夏(用热水洗七遍,去掉滑腻后焙干)、五味子、青橘皮(用热水浸泡,去掉白色内瓤后焙干)、杏仁(用热水浸泡,去掉皮和尖,双仁者用麦麸炒制)、桂枝(去掉粗皮,各一两)、赤茯苓、甘草(炙制,各半两)。
以上八味药捣成粗末过筛,每次服用五钱匕,加水一盏半,放入切碎的生姜半分,一同煎煮取七分药液,去渣温服。不拘定时间服用。
治疗肺胃有寒,导致上气呕吐,伴有胸满、不能进食的胡椒丸方:
胡椒(去掉黑皮)、陈橘皮(用热水浸泡,去掉白色内瓤后焙干)、甘草(炙制并锉碎)、紫菀(去掉苗土,各一两)、桂枝(去掉粗皮)、诃黎勒(煨制)。
以上十二味药,捣碎过罗制成细末,用炼蜜制成梧桐子大小的丸剂,每次服用三十丸。用生姜和陈橘皮煎汤送服,不拘定时间,每日三次服用。
治疗上气,进食即吐逆的七气汤方:
草豆蔻(去皮生用)、人参、赤茯苓(去掉黑皮)、白术、大腹皮(连皮生用并锉碎)、诃黎勒(煨制去核,各半两)。
以上七味药,捣成粗末过筛,每次服用三钱匕,加水一盏,煎至六分药液,去渣温服。如果不想吃东西,可加入生姜煎服。
治疗气逆,进食则呕吐的半夏汤方:
半夏(用热水洗七遍,去掉滑腻后切片焙干)、生姜、陈橘皮(用热水浸泡,去掉内瓤后焙干,各二两)、桂枝(去掉粗皮,一两)。
以上四味药,切碎。分为两剂,每剂加水五盏,煎取二盏药液,去渣分三次温服,空腹饮用。
治疗上气,痰壅盛导致呕吐的诃黎勒汤方:
诃黎勒(煨制去核,二两)、陈橘皮(用热水浸泡,去掉白色内瓤后焙干,各一两)、甘草(炙制锉碎,半两)、人参(三分)、前胡(去掉芦头,一两)、杏仁(用热水浸泡,去掉皮和尖,双仁者用麦麸炒黄,一两半)、白术、槟榔(锉碎)、紫苏茎叶(各一两)。
以上十一味药,捣成粗末过筛,每次服用五钱匕,加水一盏半,放入生姜五片、大枣三枚劈破,一同煎至七分药液,去渣不拘时间温服。
治疗上气呕吐不止的芫花散方:
芫花(一两,醋炒)、肉豆蔻(去壳锉碎)、槟榔(锉碎,各一枚)。
以上三味药,捣碎过罗制成细散,每次服用一钱匕,用煨热的葱白一寸,温酒调服。
治疗上气呕逆,不能进食的半夏汤方:
半夏(用热水洗七遍,去掉滑腻,一两)、干桑叶(六两)、干姜(炮制,一分)。
以上三味药,捣成粗末过筛,每次服用三钱匕,加生姜五片、浆水一盏,煎至六分药液,去渣稍热时服用。不拘定时间。
治疗上气呕吐,不能进食的半夏汤方:
半夏(用热水洗七遍,去掉滑腻后焙干,三分)、白术、人参(一两)、桂枝(去掉粗皮)、甘草(炙制锉碎)、陈橘皮(用热水浸泡,去掉白色内瓤后焙干)。
以上七味药,捣成粗末过筛,每次服用五钱匕,加水一盏半,放入生姜五片、大枣三枚劈破,煎至七分药液,去渣温服,每日三次。
治疗上气呕吐的芥子丸方:
芥子(五两)。
以上一味药,捣碎过罗制成细末,用炼蜜制成梧桐子大小的丸剂,每次服用七丸,在寅时用井华水(清晨第一次打的井水)送服。也可以制成散剂,空腹用酒送服。
治疗上气呕逆,以及疏利过度导致虚气上攻的压气散方:
木香、人参、白茯苓(去掉黑皮)、藿香叶、陈橘皮(用热水浸泡,去掉白色内瓤后焙干)、枳壳(去掉内瓤,麦麸炒制)、甘草(炙制锉碎,各等份)。
以上八味药,捣碎过罗制成散剂,每次服用二钱匕,用紫苏、木瓜、生姜煎汤调服,再倒入银盏中,隔水加热煮沸五六次,温服。
治疗上气呕吐,或胸中痰饮停滞积聚导致呕吐的人参散方:
人参、白术(锉碎炒制,各二两)、白茯苓(去掉黑皮,一两)、甘草(炙制锉碎)、干姜(炮制,各半两)、粟米一合。
以上六味药,捣碎过罗制成散剂,每次服用二钱匕,用竹茹和生姜煎汤调服。
Commentary states: Upper Qi and vomiting refer to the upward reversal of Qi that fails to descend, which is caused by deficiency in the Lung and Stomach. The Lung meridian originates from the Middle Jiao (Middle Burner) and loops around the cardia of the Stomach. When Cold pathogen invades the Lung, it causes Lung Qi to reverse with panting and chest fullness, impairing the ascending and descending mechanisms. Phlegm-fluids stagnate and accumulate in the Middle Jiao. When Qi agitates the Stomach, Stomach Qi reverses upward, resulting in vomiting.
Zisuzi Tang Decoction for treating Upper Qi and vomiting accompanied by chest fullness and difficult breathing:
Perillae Fructus (Zisuzi), Pinelliae Rhizoma Preparatum (Banxia, washed seven times with hot water, dried after removing slipperiness), Schisandrae Fructus (Wuweizi), Aurantii Fructus Viridis (Qingjupi, soaked in hot water, dried after removing the white pith), Armeniacae Semen Amarum (Xingren, soaked in hot water, peeled, de-veined, double-kernel variety stir-fried with bran), Cinnamomi Ramulus (Guizhi, bark removed), Poria Cum Radix Polypori Rubra (Chifuling), Glycyrrhizae Radix et Rhizoma Preparata (Zhigancao, each 1 liang).
The above eight herbs are coarsely crushed and sifted. Each dose consists of 5 qianbi, boiled with 1.5 sheng of water. Add 0.5 fen of sliced fresh ginger, decoct until 0.7 sheng remains, strain, and take warm. Take at any time.
Hujiao Wan Pills for treating Cold in the Lung and Stomach causing Upper Qi and vomiting, accompanied by chest fullness and anorexia:
Piperis Fructus (Hujiao, black skin removed), Citri Reticulatae Pericarpium (Chenjuapi, soaked in hot water, dried after removing the white pith), Glycyrrhizae Radix et Rhizoma Preparata (Zhigancao, prepared and cut), Asteris Radix et Rhizoma (Ziwan, seedlings and soil removed, each 1 liang), Cinnamomi Ramulus (Guizhi, bark removed), Chebulae Fructus (Helile, baked).
The above twelve herbs are crushed, sieved into fine powder, and mixed with refined honey to form pills the size of paulownia seeds. Each dose is 30 pills, taken with a decoction of fresh ginger and Chenjuapi. Take at any time, three times daily.
Qiqi Tang Decoction for treating Upper Qi where food intake immediately triggers regurgitation:
Alpiniae Katsumadai Semen (Caodoukou, peeled, raw use), Ginseng Radix (Renshen), Poria Cum Radix Polypori Rubra (Chifuling, black skin removed), Atractylodis Macrocephalae Rhizoma (Baizhu), Arecae Pericarpium (Dafu, whole peel used, raw and cut), Chebulae Fructus (Helile, baked and pitted, each 0.5 liang).
The above seven herbs are coarsely crushed and sifted. Each dose is 3 qianbi, boiled with 1 sheng of water until 0.6 sheng remains. Strain and take warm. If appetite is poor, add fresh ginger and decoct.
Banxia Tang Decoction for treating Qi reversal and vomiting upon eating:
Pinelliae Rhizoma Preparatum (Banxia, washed seven times with hot water, sliced and dried), Zingiberis Rhizoma Recens (Shengjiang), Citri Reticulatae Pericarpium (Chenjuapi, soaked in hot water, pulp removed, dried, each 2 liang), Cinnamomi Ramulus (Guizhi, bark removed, 1 liang).
The above four herbs are chopped. Divide into two doses. Each dose is boiled with 5 sheng of water until 2 sheng remains. Strain and divide into three warm doses. Drink on an empty stomach.
Helile Tang Decoction for treating Upper Qi and vomiting due to phlegm obstruction:
Chebulae Fructus (Helile, baked and pitted, 2 liang), Citri Reticulatae Pericarpium (Chenjuapi, soaked in hot water, dried after removing white pith, each 1 liang), Glycyrrhizae Radix et Rhizoma Preparata (Zhigancao, prepared and cut, 0.5 liang), Ginseng Radix (Renshen, 3 fen), Peucedani Radix (Qianhu, radicle removed, 1 liang), Armeniacae Semen Amarum (Xingren, soaked in hot water, peeled, de-veined, double-kernel variety stir-fried with bran until yellow, 1.5 liang), Atractylodis Macrocephalae Rhizoma (Baizhu), Areca Seed (Binglang, cut), Perillae Caulis et Folium (Zisujingye, each 1 liang).
The above eleven herbs are coarsely crushed and sifted. Each dose is 5 qianbi, boiled with 1.5 sheng of water. Add five slices of fresh ginger and three cracked jujubes. Decoct until 0.7 sheng remains. Strain and take warm at any time.
Yuanhua San Powder for treating persistent Upper Qi and vomiting:
Genkwa Flos (Yuanhua, 1 liang, stir-fried with vinegar), Myristicae Semen (Roudoukou, shell removed and cut), Areca Seed (Binglang, cut, one piece each).
The above three herbs are crushed and sieved into fine powder. Each dose is 1 qianbi, taken with warm wine and one inch of baked scallion white.
Banxia Tang Decoction for treating Upper Qi, retching, and inability to eat:
Pinelliae Rhizoma Preparatum (Banxia, washed seven times with hot water, 1 liang), Mori Folium Siccatum (Gangsanye, 6 liang), Zingiberis Rhizoma Siccatum (Ganjiang, processed, 1 fen).
The above three herbs are coarsely crushed and sifted. Each dose is 3 qianbi, boiled with five slices of fresh ginger and 1 sheng of fermented grain water until 0.6 sheng remains. Strain and take slightly warm. Take at any time.
Banxia Tang Decoction for treating Upper Qi and vomiting with inability to ingest food:
Pinelliae Rhizoma Preparatum (Banxia, washed seven times with hot water, dried, 3 fen), Atractylodis Macrocephalae Rhizoma (Baizhu), Ginseng Radix (Renshen, 1 liang), Cinnamomi Ramulus (Guizhi, bark removed), Glycyrrhizae Radix et Rhizoma Preparata (Zhigancao, prepared and cut), Citri Reticulatae Pericarpium (Chenjuapi, soaked in hot water, dried after removing white pith).
The above seven herbs are coarsely crushed and sifted. Each dose is 5 qianbi, boiled with 1.5 sheng of water. Add five slices of fresh ginger and three cracked jujubes. Decoct until 0.7 sheng remains. Strain and take warm, three times daily.
Jiezi Wan Pills for treating Upper Qi and vomiting:
Sinapis Semen (Jiezi, 5 liang).
The above single herb is crushed and sieved into fine powder, mixed with refined honey to form pills the size of paulownia seeds. Each dose is 7 pills, taken with well-water drawn at dawn (Yin hour). It can also be made into powder and taken with wine on an empty stomach.
Yaqi San Powder for treating Upper Qi, retching, excessive purgation leading to deficient Qi attacking upward:
Aquari Tugongmu (Muxiang), Ginseng Radix (Renshen), Poria (Baifuling, black skin removed), Agastachis Herba (Huoxiangye), Citri Reticulatae Pericarpium (Chenjuapi, soaked in hot water, dried after removing white pith), Aurantii Fructus (Zhike, pulp removed, stir-fried with bran), Glycyrrhizae Radix et Rhizoma Preparata (Zhigancao, prepared and cut, equal parts).
The above eight herbs are crushed and sieved into powder. Each dose is 2 qianbi, mixed with a decoction of Perilla, Chaenomelis Fructus, and fresh ginger. Pour into a silver cup and heat over boiling water for five to seven boils. Take warm.
Renshen San Powder for treating Upper Qi and vomiting, or phlegm-fluids stagnating in the chest causing vomiting:
Ginseng Radix (Renshen), Atractylodis Macrocephalae Rhizoma (Baizhu, cut and stir-fried, each 2 liang), Poria (Baifuling, black skin removed, 1 liang), Glycyrrhizae Radix et Rhizoma Preparata (Zhigancao, prepared and cut), Zingiberis Rhizoma Siccatum (Ganjiang, processed, each 0.5 liang), Setaria Italica (Sumi, 1 he).
The above six herbs are crushed and sieved into powder. Each dose is 2 qianbi, taken with a decoction of Bamboo Shavings (Zhuru) and fresh ginger.