论曰内经谓黄脉之至也,大而虚,有积气在腹中,有厥气名曰厥疝,女子同法,得之疾
使四肢,汗出当风,夫疝藏疾,言隐而难见,阴沉而伏也,今脾虚风寒客于腹膜之间,不能
与胃通行水谷之气,结而成积,使气道厥逆而痛,故谓之厥疝。
治厥疝腹中阴冷痛,积气上逆,吴茱萸汤方
吴茱萸(汤洗焙干炒二两) 乌头(炮裂去皮脐) 细辛(去苗叶各三分) 高良姜(锉
炒)
上七味,锉如麻豆大,每服五钱匕,以水二盏,煎取一盏,去滓温服,日二。
治厥疝上攻,腹痛无时, 香丸方
香子(炒) 吴茱萸(汤洗焙干炒) 桂(去粗皮) 胡椒 楝实(锉碎麸炒) 延
胡索(各
一分)
上一十二味,捣罗为细末,酒煮面糊和丸,如梧桐子大,每服十丸,盐酒下,食前服。
治厥疝上抢,心腹冷痛,山茱萸丸方
山茱萸 吴茱萸(汤洗焙干炒) 食茱萸 楝实(锉碎麸炒) 马蔺花 香子(炒) 青
橘
重半两者炮
上一十一味,捣罗为细末,醋煮面糊和丸,如梧桐子大,每服二十丸,酒或盐汤下,空
心服。
治厥疝、腹中冷痛,当归干姜汤方
当归(切焙) 干姜(炮) 附子(炮裂去皮脐) 人参 甘草(炙锉) 细辛(去苗
叶) 芍药
上七味, 咀如麻豆,每服三钱匕,水一盏,煎七分,去滓温服,不拘时。
治厥疝逆上,攻腹冷痛,木香汤方
木香 槟榔(生锉) 乌头(炮裂去皮脐) 细辛(去苗叶) 当归(切焙) 吴茱萸
(汤洗焙
上八味 咀如麻豆,每服三钱匕,水一盏,煎七分,去滓温服,不拘时。
治厥疝冷逆,攻心腹痛,细辛丸方
细辛(去苗叶) 芍药 吴茱萸(汤洗焙干炒) 人参 白术 桂(去粗皮) 干姜(炮)
甘草(炙锉) 当归(切焙) 附子(炮裂去皮脐各一两)
上一十味,捣罗为细末,稀面糊丸,如梧桐子大,空心米饮下三十丸,日三。
论述说:《内经》提到,黄脉(脾脉)到来时,脉象大而虚,腹中有积滞之气,伴有厥逆之气,这种病称为厥疝,女子的发病机理与此相同。此病多因患疾后急于使唤四肢劳作,汗出时当风受邪所致。所谓“疝”为藏匿之疾,意指病位隐蔽且难以察觉,其性质属阴,沉伏于内。如今脾脏虚弱,风寒之邪客居于腹膜之间,不能与胃共同运化水谷的精微之气,导致气机结聚而成积块,致使气道厥逆而疼痛,因此称之为厥疝。
治疗厥疝引起的腹中阴冷疼痛,积气上逆,使用吴茱萸汤方:
吴茱萸(用汤洗净,焙干,炒制,二两)、乌头(炮裂,去皮及脐)、细辛(去苗和叶,各三分)、高良姜(锉碎,炒制)。
以上七味药,锉成如麻豆大小的颗粒,每次服用五钱匕,用水二盏,煎煮取一盏,滤去药渣,温服,每日两次。
治疗厥疝之气上攻,腹痛发作无定时,使用香丸方:
香子(炒制)、吴茱萸(用汤洗净,焙干,炒制)、桂枝(去除粗皮)、胡椒、楝实(锉碎,用麸皮炒制)、延胡索(各一分)。
以上十二味药,捣碎过筛成为细末,用酒煮面糊调和制成丸剂,大小如梧桐子,每次服用十丸,用盐酒送下,饭前服用。
治疗厥疝之气上冲,心腹冷痛,使用山茱萸丸方:
山茱萸、吴茱萸(用汤洗净,焙干,炒制)、食茱萸、楝实(锉碎,用麸皮炒制)、马蔺花、香子(炒制)、青橘皮(重半两者需炮制)。
以上十一味药,捣碎过筛成为细末,用醋煮面糊调和制成丸剂,大小如梧桐子,每次服用二十丸,用酒或盐汤送下,空腹服用。
治疗厥疝、腹中冷痛,使用当归干姜汤方:
当归(切,焙干)、干姜(炮制)、附子(炮裂,去皮及脐)、人参、甘草(炙烤,锉碎)、细辛(去苗和叶)、芍药。
以上七味药,锉成如麻豆大小,每次服用三钱匕,用水一盏,煎煮至七分,滤去药渣,温服,不拘泥于固定时间。
治疗厥疝之气逆上,攻冲腹部冷痛,使用木香汤方:
木香、槟榔(生锉)、乌头(炮裂,去皮及脐)、细辛(去苗和叶)、当归(切,焙干)、吴茱萸(用汤洗净,焙干)。
以上八味药,锉成如麻豆大小,每次服用三钱匕,用水一盏,煎煮至七分,滤去药渣,温服,不拘泥于固定时间。
治疗厥疝冷逆之气,攻冲心腹疼痛,使用细辛丸方:
细辛(去苗和叶)、芍药、吴茱萸(用汤洗净,焙干,炒制)、人参、白术、桂枝(去除粗皮)、干姜(炮制)、甘草(炙烤,锉碎)、当归(切,焙干)、附子(炮裂,去皮及脐,各一两)。
以上十味药,捣碎过筛成为细末,用稀面糊制成丸剂,大小如梧桐子,空腹时用米饮送下三十丸,每日三次。
It is stated in the discussion: The *Neijing* (Classic of Internal Medicine) mentions that when the Huang pulse (Spleen pulse) arrives, it appears large and empty. There is accumulated qi in the abdomen accompanied by Jue qi (rebellious cold qi), a condition named Jue Shan (Jue Hernia). Women are subject to the same pathological mechanism. This disease often arises from exerting the limbs hastily after illness while sweating and exposing oneself to wind. "Shan" refers to a hidden disease, implying that the lesion is concealed and difficult to detect; its nature is Yin, sinking and latent within. Currently, due to Spleen deficiency, Wind-Cold pathogens lodge between the abdominal membranes. They fail to transport and transform the Qi of water and grain together with the Stomach, leading to the knotting of Qi into an accumulation. This causes the Qi pathway to become rebellious and painful, hence it is called Jue Shan.
For treating Jue Shan characterized by Yin-cold pain in the abdomen and rebellious upward movement of accumulated qi, use Wuzhuyu Tang (Evodia Decoction):
Wuzhuyu (Evodiae Fructus, washed with decoction, dried, stir-fried, 2 liang); Wutou (Aconiti Lateralis Radix Praeparata, processed until cracked, peel removed, umbilical scar removed); Xixin (Asari Radix, remove seedlings and leaves, each 3 fen); Gaoliangjiang (Alpiniae Officinarum Rhizoma, chopped, stir-fried).
The above seven ingredients are chopped to the size of hemp seeds. Each dose consists of 5 qianbi (approx. 15-20g depending on era measurement, literally "five coin-sized scoops"). Boil with 2 zhan (approx. 400ml) of water until 1 zhan remains. Strain and take warm. Twice daily.
For treating Jue Shan where qi attacks upward causing intermittent abdominal pain without fixed timing, use Xiang Wan (Xiang Pill):
Xiangzi (Litseae Fructus, stir-fried); Wuzhuyu (Evodiae Fructus, washed with decoction, dried, stir-fried); Gui (Cinnamomi Ramulus, remove rough bark); Hujiao (Piperis Longi Fructus); Lianshi (Meliae Fructus, chopped, stir-fried with bran); Yanhusuo (Corydalis Rhizoma, each 1 fen).
The above twelve ingredients are pounded and sieved into fine powder. Mix with paste made from flour boiled in wine to form pills, sized like paulownia seeds. Take 10 pills per dose, administered with salted wine before meals.
For treating Jue Shan where qi rushes upward causing cold pain in the heart and abdomen, use Shanzhuyu Wan (Cornus Pill):
Shanzhuyu (Corni Fructus); Wuzhuyu (Evodiae Fructus, washed with decoction, dried, stir-fried); Shizhuyu (Zanthoxyli Fructus); Lianshi (Meliae Fructus, chopped, stir-fried with bran); Malinhua (Iridis Flos); Xiangzi (Litseae Fructus, stir-fried); Qingju (Citri Reticulatae Pericarpium, half liang requires processing).
The above eleven ingredients are pounded and sieved into fine powder. Mix with paste made from flour boiled in vinegar to form pills, sized like paulownia seeds. Take 20 pills per dose, administered with wine or salted water on an empty stomach.
For treating Jue Shan and cold pain in the abdomen, use Danggui Ganjiang Tang (Angelica Sinensis and Dried Ginger Decoction):
Danggui (Angelicae Sinensis Radix, cut, dried); Ganjiang (Zingiberis Rhizoma, processed); Fuzi (Aconiti Lateralis Radix Praeparata, processed until cracked, peel removed, umbilical scar removed); Renshen (Ginseng Radix et Rhizoma); Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, chopped); Xixin (Asari Radix, remove seedlings and leaves); Shaoyao (Paeoniae Radix Alba).
The above seven ingredients are chopped to the size of hemp seeds. Each dose consists of 3 qianbi. Boil with 1 zhan of water until 7/10 remains. Strain and take warm at any time.
For treating Jue Shan where rebellious qi attacks causing cold pain in the abdomen, use Muxiang Tang (Costus Decoction):
Muxiang (Aucklandiae Radix); Binglang (Arecae Semen, raw, chopped); Wutou (Aconiti Lateralis Radix Praeparata, processed until cracked, peel removed, umbilical scar removed); Xixin (Asari Radix, remove seedlings and leaves); Danggui (Angelicae Sinensis Radix, cut, dried); Wuzhuyu (Evodiae Fructus, washed with decoction, dried).
The above eight ingredients are chopped to the size of hemp seeds. Each dose consists of 3 qianbi. Boil with 1 zhan of water until 7/10 remains. Strain and take warm at any time.
For treating Jue Shan with cold rebellious qi attacking the heart and abdomen causing pain, use Xixin Wan (Asari Pill):
Xixin (Asari Radix, remove seedlings and leaves); Shaoyao (Paeoniae Radix Alba); Wuzhuyu (Evodiae Fructus, washed with decoction, dried, stir-fried); Renshen (Ginseng Radix et Rhizoma); Baizhu (Atractylodis Macrocephalae Rhizoma); Gui (Cinnamomi Ramulus, remove rough bark); Ganjiang (Zingiberis Rhizoma, processed); Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, chopped); Danggui (Angelicae Sinensis Radix, cut, dried); Fuzi (Aconiti Lateralis Radix Praeparata, processed until cracked, peel removed, umbilical scar removed, each 1 liang).
The above ten ingredients are pounded and sieved into fine powder. Form pills with thin flour paste, sized like paulownia seeds. Take 30 pills per dose with rice drink on an empty stomach, three times daily.