有物有声谓之呕,有物无声吐证名,无物有声为哕证,分别医治中病情。
【注】吐证有三∶曰呕,曰吐,曰哕。古人谓呕属阳明,有声有物,气血俱病也;吐
属太阳,有物无声,血病也;哕属少阳,有声无物,气病也。独李杲谓呕、吐、哕俱属
脾胃虚弱。洁古老人又从三焦以分气、积、寒之三因。然皆不外诸逆上冲也。治者能分虚
实,别寒热以治之,自无不曲中病情矣。
乳食过饱蓄胃中,乳片不化吐频频,身热面黄腹膨胀,消乳保和有神功。
【注】伤乳吐者,因乳食过饱,停蓄胃中,以致运化不及,吐多乳片,犹如物盛满而上
溢也。其证身热面黄,肚腹膨胀。治宜消乳丸、保和丸。化其宿乳,安胃和中,节其乳食,自然止也
消乳丸
香附(制,二两) 神曲(炒) 麦芽(炒,各一两) 陈皮(八钱) 缩砂仁(炒) 甘草(炙,
各五钱)
上为细末,滴水为丸,如粟米大,量儿大小与之,姜汤化下。
保和丸
南山楂(二两) 神曲(炒,一两) 茯苓 半夏(姜制,各一两) 连翘(去心) 陈皮 莱菔子
(炒,各五钱)
上为细末,面糊为丸,麦芽汤化服。
过食伤胃腹胀热,恶食口臭吐酸粘,眼胞虚浮身潮热,须服三棱和胃煎。
【注】伤食吐者,因小儿饮食无节,过食油腻、面食等物,以致壅塞中脘而成也,其
证肚腹胀热,恶食口臭,频吐酸粘,眼胞虚浮,身体潮热。治宜清胃和中为主。先用三
棱丸止其吐,再用和胃汤化其滞,而病渐愈矣。
三棱丸
三棱(煨) 陈皮 半夏(姜制) 神曲(炒,各一两) 黄连(姜炒) 枳实(麸炒) 丁香(各
五钱)
上研细末,面和为丸,如黄米大,每服二十丸,食后姜汤下。
和胃汤
陈皮 半夏(姜制) 缩砂仁(研) 苍术(炒) 浓朴(姜炒) 藿香叶 香附(炒) 甘
草(炙) 山楂 神曲(炒)
引用生姜,水煎服。
【方歌】和胃汤治呕吐频,陈皮半夏缩砂仁,苍术浓朴藿香叶,香附甘草山楂神。
有实物排出且伴有声音的称为“呕”,有实物排出但无声响的称为“吐”,无实物排出仅有声音的称为“哕”,在临床治疗中需根据具体病情进行区分。
【注释】呕吐类病症主要有三种:即“呕”、“吐”、“哕”。古人认为,“呕”归属于阳明经,既有声音又有实物排出,说明气血均受病邪影响;“吐”归属于太阳经,只有实物排出而无声音,属于血分病变;“哕”归属于少阳经,只有声音而无实物排出,属于气分病变。唯独李杲(李东垣)认为“呕”、“吐”、“哕”均归属于脾胃虚弱所致。洁古老人(张元素)则进一步从三焦角度区分了气、积、寒这三种致病原因。然而,这些观点都不外乎各种气机逆乱上冲的情况。医生若能分辨虚实,辨别寒热来进行治疗,自然能准确地契合病情。
乳汁或食物摄入过量积聚在胃中,乳片无法消化而频繁呕吐,身体发热、面色发黄、腹部胀满,服用消乳丸和保和丸具有神奇功效。
【注释】伤乳吐,是因为乳汁或食物吃得过饱,停滞蓄积在胃中,导致脾胃运化功能不及,呕吐物中多含有未消化的乳片,就像容器盛满后溢出一样。其症状表现为身体发热、面色萎黄、肚腹膨胀。治疗宜采用消乳丸、保和丸。以化解滞留的乳汁,安抚胃部并调和中焦,同时节制乳汁和食物的摄入,病情自然会停止。
消乳丸
香附(制,二两) 神曲(炒) 麦芽(炒,各一两) 陈皮(八钱) 缩砂仁(炒) 甘草(炙,各五钱)
以上药材研为细末,用滴水法制成丸剂,大小如粟米,根据患儿年龄大小给予剂量,用姜汤送服化开。
保和丸
南山楂(二两) 神曲(炒,一两) 茯苓 半夏(姜制,各一两) 连翘(去心) 陈皮 莱菔子(炒,各五钱)
以上药材研为细末,用面糊制成丸剂,用麦芽汤送服。
饮食过量损伤胃部导致腹胀发热,厌恶进食、口中有臭味、呕吐酸粘液体,眼睑虚浮、身体出现潮热,必须服用三棱和胃煎。
【注释】伤食吐,是因为小儿饮食没有节制,过量食用油腻、面食等食物,导致食物壅塞在中脘部位而形成。其症状表现为肚腹胀热、厌恶进食、口中有臭味、频繁呕吐酸粘之物、眼睑虚浮、身体出现潮热。治疗应以清胃和中为主。先用三棱丸止住呕吐,再用和胃汤化解积滞,病情就会逐渐痊愈。
三棱丸
三棱(煨) 陈皮 半夏(姜制) 神曲(炒,各一两) 黄连(姜炒) 枳实(麸炒) 丁香(各五钱)
以上药材研为细末,用面粉和合制成丸剂,大小如黄米,每次服用二十丸,饭后用姜汤送服。
和胃汤
陈皮 半夏(姜制) 缩砂仁(研) 苍术(炒) 浓朴(姜炒) 藿香叶 香附(炒) 甘草(炙) 山楂 神曲(炒)
引用生姜作为药引,加水煎煮后服用。
There is a substance expelled accompanied by sound, which is termed "Ou" (vomiting with sound); there is a substance expelled without sound, which is termed "Tu" (spitting up/vomiting without sound); there is no substance expelled but only sound, which is termed "Yue" (hiccups/belching). Treatment must distinguish the specific condition.
[Note] There are three types of vomiting syndromes: namely "Ou", "Tu", and "Yue". The ancients stated that "Ou" belongs to the Yangming channel, presenting with both sound and substance, indicating that both Qi and Blood are diseased; "Tu" belongs to the Taiyang channel, presenting with substance but no sound, indicating a disease of the Blood aspect; "Yue" belongs to the Shaoyang channel, presenting with sound but no substance, indicating a disease of the Qi aspect. Only Li Gao (Li Dongyuan) asserted that "Ou", "Tu", and "Yue" all belong to Spleen-Stomach deficiency. Jiegou Laoren (Zhang Yuansu) further differentiated the three causes—Qi, Accumulation, and Cold—from the perspective of the Triple Burner. However, none of these exceed the concept of various rebellious upward rushing of Qi. If the practitioner can differentiate between Deficiency and Excess, and distinguish Cold from Heat in treatment, they will naturally hit the mark accurately regarding the condition.
Excessive intake of milk or food accumulates in the Stomach; undigested milk curds are vomited frequently; the body has fever, the face is yellowish, and the abdomen is distended. Xiao Ru Wan (Milk-Digesting Pill) and Bao He Wan (Preserve Harmony Pill) possess miraculous efficacy.
[Note] Milk-injury vomiting occurs because milk or food is consumed in excess, stagnating and accumulating in the Stomach, leading to insufficient transportation and transformation. The vomit contains much undigested milk curd, resembling overflow when a container is full. The symptoms include body fever, sallow complexion, and abdominal distension. Treatment should employ Xiao Ru Wan and Bao He Wan to resolve retained milk, soothe the Stomach, harmonize the Middle Jiao, and regulate milk and food intake, after which the condition will naturally cease.
Xiao Ru Wan (Milk-Digesting Pill)
Cyperi Rhizoma preparata (Xiangfu, prepared, 2 liang), Medicated Leaven preparata (Shenqu, fried), Malto (Maiya, fried, each 1 liang), Citri Reticulatae Pericarpium (Chenpi, 8 qian), Amomi Fructus preparata (Suosharen, fried), Glycyrrhizae Radica et Rhizoma preparata (Gancao, roasted, each 5 qian).
Grind into fine powder, form pills with water drops, size like millet seeds. Administer according to the child's age/size, dissolve and take with Ginger Decoction.
Bao He Wan (Preserve Harmony Pill)
Crataegi Fructus (Nanshan Zha, 2 liang), Medicated Leaven preparata (Shenqu, fried, 1 liang), Poria (Fuling), Pinelliae Rhizoma preparata (Banxia, ginger-processed, each 1 liang), Forsythiae Fructum (Lianqiao, heart removed), Citri Reticulatae Pericarpium (Chenpi), Raphani Semen preparatum (Laifuzi, fried, each 5 qian).
Grind into fine powder, form pills with wheat paste, take with Malt Decoction.
Overeating injures the Stomach causing abdominal distension and heat; aversion to food, foul breath, vomiting of sour sticky fluid; eyelids are puffy, body has tidal fever. San Leng He Wei Jian (Trichosanthes Root and Stomach-Harmonizing Decoction) must be taken.
[Note] Food-injury vomiting occurs because children eat without restraint, overconsuming greasy foods, noodles, etc., leading to obstruction in the Zhongwan region. Symptoms include abdominal distension and heat, aversion to food, foul breath, frequent vomiting of sour sticky matter, puffy eyelids, and tidal fever. Treatment should primarily clear the Stomach and harmonize the Middle. First use San Leng Wan to stop vomiting, then use He Wei Tang to resolve stagnation, and the illness will gradually heal.
San Leng Wan (Trichosanthes Root Pill)
Curcumae Rhizoma (Sanleng, roasted), Citri Reticulatae Pericarpium (Chenpi), Pinelliae Rhizoma preparata (Banxia, ginger-processed), Medicated Leaven preparata (Shenqu, fried, each 1 liang), Coptidis Rhizoma (Huanglian, ginger-fried), Immature Bitter Orange (Zhishi, bran-roasted), Syzygii Arillatus (Dingxiang, each 5 qian).
Grind into fine powder, form pills with flour paste, size like broomcorn millet. Take 20 pills per dose, swallow with Ginger Decoction after meals.
He Wei Tang (Stomach-Harmonizing Decoction)
Citri Reticulatae Pericarpium (Chenpi), Pinelliae Rhizoma preparata (Banxia, ginger-processed), Amomi Fructus preparata (Suosharen, ground), Atractylodis Rhizoma (Cangzhu, fried), Magnoliae Officinalis Cortex (N Houpo, ginger-fried), Agastachis Herba (Huoxiangye), Cyperi Rhizoma (Xiangfu, fried), Glycyrrhizae Radica et Rhizoma preparata (Gancao, roasted), Crataegi Fructus (Shanzha), Medicated Leaven preparata (Shenqu, fried).
Use fresh Ginger as a guide drug, decoct in water and take.
[Formula Song] He Wei Tang treats frequent vomiting, containing Chenpi, Banxia, Suosharen, Cangzhu, N Houpo, Huoxiangye, Xiangfu, Gancao, Shanzha, Shenqu.