论曰∶凡人有五脏,合则脾胃为水谷之府,且国府足谷,则足食足兵也。人胃足食,则
营卫不厥,若人能食则能悦也。阴阳和平,有何患乎,若服食之人,皆增于热,失时不食,
则胃口干焦,胃口干焦,则土不足,或因饮酒水,而食少变为痰结,酒水流下,迎令上升,
下焦无阳,即阳虚也,中腑无谷,上焦渐炎,致阳呕哕,经曰,阳数即呕吐,又曰呕哕发下
焦之间,此之义也,可以破痰结,通水谷,填胃腑,则无咎也,夫通填之义,不可虚其虚,
实其
疗因饥空腹饮酒饮水,食少痰结心头干呕方。
枳实(三两炙) 栀子仁(一两) 香豉(半升) 大黄(二两别浸)
上四味切,以水六升,煮取二升,分再服,忌如常法。
又疗结热 ,心下肿,胸中痞塞,呕逆不止,雁肪汤方。
雁肪(一具) 甘草(炙) 当归 桂心 芍药 人参 石膏(各二两碎) 桃仁(三
十枚去
皮尖) 大枣(二十枚擘) 大黄(二两)
上十味切,以水一斗二升煮雁肪,取汁一斗煮诸药,取五升,去滓分服,无雁肪,以雁
肉,无雁以鸭代之,鸡亦得。
又疗呕不止,不下食方。
薤白(一握) 橘皮(一两) 豉(半升) 麦门冬(二两去心) 粟米(一合)
上五味切,以水三升,煮取一升,去滓细细服之,瘥止。
又疗热发,胸中痰醋,干呕烦热方。
半夏(洗) 白薇(各一两) 干姜(一两) 甘草(半两炙)
上四味切,以苦酒五升,煮取三升,分服,夫苦酒能令石朽烂,故用之。
又疗数振动,烦闷呕逆,人参汤方。
人参 甘草(炙) 栝蒌 麦门冬(去心各二两) 黄芩 芦根(各一两)
上六味切,以水四升,煮取二升,分四服瘥止。
论述说:大凡人有五脏,其中脾胃是受纳水谷的府库。就像国家粮仓充足,就能做到粮食充足、军备充实一样。人的胃中食物充足,那么营气和卫气就不会逆乱;如果人能够进食,精神就会愉悦。阴阳保持平和状态,还有什么忧患呢?如果是那些服用丹药(服食之人),体内都会增加热邪,若又错过正常进食时间,就会导致胃口干燥焦枯。胃口干燥焦枯,则脾土之气不足;有时因为饮酒或喝水,导致饮食减少而变为痰结。酒液流注下行,顺应时令之气上升,导致下焦没有阳气,这就是阳虚。中焦脏腑缺乏水谷精微,上焦逐渐产生炎火,从而导致阳气的呕吐和呃逆。医经上说,阳气偏盛频繁就会出现呕吐,又说呕吐和呃逆发源于下焦之间,说的就是这个道理。因此,可以破除痰结,疏通水谷通道,填补胃腑,这样就没有灾祸了。所谓“通”和“填”的含义,不能使虚弱者更虚,而要使其充实。
治疗因饥饿空腹饮酒饮水,饮食少而生痰结于心头引起干呕的方剂:
枳实(三两,炙) 栀子仁(一两) 香豉(半升) 大黄(二两,另浸泡)
以上四味药切碎,用水六升,煮取二升药汁,分两次服用,忌口遵循常规方法。
又治疗热邪郁结,心下部肿胀,胸中痞塞不通,呕吐逆气不止的雁肪汤方:
雁肪(一只) 甘草(炙) 当归 桂心 芍药 人参 石膏(各二两,捣碎) 桃仁(三十枚,去皮尖) 大枣(二十枚,掰开) 大黄(二两)
以上十味药切碎,先用水一斗二升煮雁肪,取汁一斗,再用此汁煮其他药物,取五升药汁,去渣分次服用。如果没有雁肪,可以用雁肉代替;没有雁,用鸭代替也可以;鸡也可以。
又治疗呕吐不止,无法进食的方剂:
薤白(一把) 橘皮(一两) 豉(半升) 麦门冬(二两,去心) 粟米(一合)
以上五味药切碎,用水三升,煮取一升药汁,去渣细细服用,病愈即停。
又治疗热邪发作,胸中有痰醋感,干呕且烦热的方剂:
半夏(洗) 白薇(各一两) 干姜(一两) 甘草(半两,炙)
以上四味药切碎,用苦酒(醋)五升,煮取三升药汁,分次服用。因为苦酒能使石头腐朽烂掉,所以用它来软坚散结。
又治疗频繁身体震颤,烦闷呕吐逆气的人参汤方:
人参 甘草(炙) 栝蒌 麦门冬(去心,各二两) 黄芩 芦根(各一两)
以上六味药切碎,用水四升,煮取二升药汁,分四次服用,病愈即停。
Commentary states: Generally, a human body possesses five zang organs, among which the Spleen and Stomach serve as the reservoirs for receiving and transforming food and fluids. Just as a nation's granaries being full ensures sufficient food and military supplies, when a person's Stomach has ample food, the Ying (Nutritive) Qi and Wei (Defensive) Qi will not become rebellious; if a person can eat, their spirit will be joyful. When Yin and Yang are in harmony, what worries could there be? However, those who consume elixirs (herbal/mineral preparations) invariably increase internal heat. If they miss regular meal times, their Stomach orifice becomes dry and scorched. A dry and scorched orifice leads to insufficiency of Earth Qi (Spleen/Stomach function). Sometimes, due to drinking alcohol or water, reduced food intake transforms into Phlegm accumulation. As wine fluid flows downward and rises upward following seasonal trends, the Lower Jiao lacks Yang Qi, resulting in Yang Deficiency. The Middle Jiao organs lack grain essence, causing gradual inflammation in the Upper Jiao, leading to Yang-type vomiting and hiccups. The Classics state that frequent Yang excess results in vomiting, and also that vomiting and hiccups originate between the Lower Jiao organs; this is the meaning here. Therefore, one can resolve phlegm accumulations, unblock the passage of food and fluids, and fill the Stomach organ, thus avoiding disaster. The principles of "unblocking" and "filling" imply that one must not further weaken the deficient, but rather strengthen them.
Formula for treating dry retching caused by phlegm accumulation in the heart region due to consuming alcohol and water on an empty stomach while hungry:
Zhi Shi (Immature Bitter Orange, prepared with fire) [3 liang]
Zhi Zi Ren (Gardenia Seed) [1 liang]
Xiang Chi (Prepared Soybean) [0.5 sheng]
Da Huang (Rhubarb Root, soaked separately) [2 liang]
Chop the above four ingredients. Decoct in 6 sheng of water until 2 sheng remains. Divide into two doses. Observe usual dietary restrictions.
Another formula, Yan Fang Tang (Wild Goose Fat Decoction), for treating constrained heat, swelling below the heart, chest stuffiness and obstruction, and incessant vomiting and regurgitation:
Yan Fang (Wild Goose Fat) [1 unit]
Gan Cao (Licorice Root, prepared with fire)
Dang Gui (Angelica Sinensis Root)
Gui Xin (Cinnamon Twig Heart)
Shao Yao (Peony Root)
Ren Shen (Ginseng Root)
Shi Gao (Gypsum Fibrosum) [each 2 liang, crushed]
Tao Ren (Peach Seed) [30 seeds, skin and tip removed]
Da Zao (Jujube Fruit) [20 fruits, split open]
Da Huang (Rhubarb Root) [2 liang]
Chop the above ten ingredients. First decoct the Wild Goose Fat in 12 sheng of water to obtain 10 sheng of juice. Then use this juice to decoct the remaining herbs until 5 sheng remains. Strain and divide into doses. If Wild Goose Fat is unavailable, Wild Goose meat may substitute; if not available, Duck may substitute; Chicken is also acceptable.
Another formula for treating incessant vomiting and inability to ingest food:
Xie Bai (Macrostemon Bulb) [1 handful]
Ju Pi (Citrus Reticulata Peel) [1 liang]
Chi (Fermented Soybean) [0.5 sheng]
Mai Men Dong (Ophiopogon Tuber) [2 liang, heart removed]
Su Mi (Millet Grain) [1 he]
Chop the above five ingredients. Decoct in 3 sheng of water until 1 sheng remains. Strain and take slowly in small sips. Discontinue when recovered.
Another formula for treating heat eruption, phlegm-acidity sensation in the chest, dry retching, and irritability with fever:
Ban Xia (Pinellia Tuber, washed)
Bai Wei (Cynanchum Atratum Root) [each 1 liang]
Gan Jiang (Dried Ginger Rhizome) [1 liang]
Gan Cao (Licorice Root, prepared with fire) [0.5 liang]
Chop the above four ingredients. Decoct in 5 sheng of Ku Jiu (Vinegar) until 3 sheng remains. Divide into doses. Ku Jiu is used because it can soften hard accumulations (metaphorically described as rotting stone).
Another formula, Ren Shen Tang (Ginseng Decoction), for treating frequent tremors, irritability, oppression, vomiting, and regurgitation:
Ren Shen (Ginseng Root)
Gan Cao (Licorice Root, prepared with fire)
Gua Lou (Trichosanthes Fruit)
Mai Men Dong (Ophiopogon Tuber, heart removed) [each 2 liang]
Huang Qin (Scutellaria Root)
Lu Gen (Reed Rhizome) [each 1 liang]
Chop the above six ingredients. Decoct in 4 sheng of water until 2 sheng remains. Divide into four doses. Discontinue when recovered.