严氏五噎散治五噎食不下呕 痰多咽喉噎塞
人参 半夏 桔梗(炒) 白豆蔻 木香 杵头糠 白术 毕澄茄 沉香 枇杷叶 干生
姜(各一两) 甘草(炙半两)
上细末每服二钱入生姜七片煎服
五膈散治五膈胸膈痞闷诸气结聚肋胁胀满痰逆恶心
枳壳(炒) 木香 青皮 大腹子 白术 半夏曲(炒) 丁香 天南星 干姜(炒) 麦
(炒) 草果仁(各一两) 甘草(炙半两)
上细末每服二钱水煎入姜
局方五膈宽中散治七情四气伤于脾胃以致胸膈痞满停痰气逆遂成五膈之病
青皮 陈皮 丁香(各四两) 浓朴(制一斤) 甘草(炙五两) 白豆蔻(一两) 香附子(
炒) 砂仁 木香(各三两)
上为末每服二钱姜盐汤点服
按以上三方并太阴阳明经药也
谨按反胃诸方古方悉是香燥大热之药皆不足为法今姑存其一二至于丹溪所言补血益阴润
燥和胃调中等药虽无其方自宜随证用之观其立论则思过半矣
杂方
烧针丸
(方见小儿门)
针经曰夫胀者皆在于脏腑之外排脏腑而廓胸胁胀皮肤故命曰胀或厥气在下荣卫留止寒气
逆上真邪相攻两气相搏乃合为胀也
按论中备五脏六腑发胀为诸证宜玩本文
内经曰诸腹胀大皆属于热 腹满 胀支鬲 胁下厥上冒过在太阴阳明乃寒湿郁遏也
原病式曰腹胀大鼓之如鼓气为阳阳为热气甚则如是也
严氏五噎散治疗五种噎证，表现为饮食难以下咽、呕吐、痰多、咽喉部有堵塞感。
人参、半夏、桔梗（炒制）、白豆蔻、木香、杵头糠、白术、毕澄茄、沉香、枇杷叶、干生姜（各一两），甘草（炙制半两）。
以上药物研为细末，每次服用二钱，加入七片生姜煎汤服用。
五膈散治疗五种膈证，表现为胸膈部位痞闷不适、各种气机结聚、肋胁部胀满、痰气上逆、恶心。
枳壳（炒制）、木香、青皮、大腹子、白术、半夏曲（炒制）、丁香、天南星、干姜（炒制）、麦（炒制）、草果仁（各一两），甘草（炙制半两）。
以上药物研为细末，每次服用二钱，用水煎煮，加入生姜同服。
局方五膈宽中散治疗因七情（喜、怒、忧、思、悲、恐、惊）和四气（风、寒、暑、湿）损伤脾胃，导致胸膈痞满、停聚痰饮、气机上逆，从而形成的五种膈病。
青皮、陈皮、丁香（各四两），浓朴（炮制一斤），甘草（炙制五两），白豆蔻（一两），香附子（炒制）、砂仁、木香（各三两）。
以上药物研为细末，每次服用二钱，用姜盐汤送服。
谨按：治疗反胃的各种古方，大多使用芳香燥烈、大热的药物，这些都不足为法。现在姑且保留其中的一两个方子。至于朱丹溪所说的补血益阴、润燥和胃、调中等药物，虽然书中没有列出具体方剂，但应当根据证候自行选用。观察他的立论观点，就已经掌握了大半的道理了。
杂方
烧针丸
（方剂见小儿门）
《针经》说：凡是胀病，都发生在脏腑之外，排挤脏腑，廓清胸胁，使皮肤胀起，所以命名为“胀”。或者是厥气在下，营卫之气停留止息，寒气逆上，真邪相互攻伐，两气相搏结，于是形成了胀病。
按语：论述中详细记载了五脏六腑发生胀病的各种证候，适宜仔细研读本文。
Yan's Five Sieve Powder (Yanshi Wuye San) treats the five types of Sieve syndrome (Wuye), characterized by difficulty in swallowing food, vomiting, excessive phlegm, and a sensation of obstruction in the throat.
Ren Shen (Ginseng Radix et Rhizoma), Ban Xia (Pinelliae Tuber), Jie Geng (Platycodonis Radix, stir-fried), Bai Dou Kou (Amomi Fructus Rotundus), Mu Xiang (Aucklandiae Radix), Chutou Kang (Rice Bran), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Bi Cheng Qie (Piperis Kadsurae Fructus), Chen Xiang (Aquilariae Lignum Resinatum), Pi Pa Ye (Loquat Leaf), Gan Sheng Jiang (Dried Fresh Ginger) (each 1 liang), Zhi Gan Cao (Honey-fried Licorice Root) (0.5 liang).
The above herbs are ground into fine powder. Each dose is 2 qian, decocted with 7 slices of fresh ginger for oral administration.
Wuge San (Five Ge Powder) treats the five types of Ge syndrome (Wuge), characterized by stifling sensation in the chest and diaphragm, accumulation of various qi stagnations, distension and fullness in the hypochondrium, rebellious phlegm-qi, and nausea.
Zhi Ke (Aurantii Fructus, stir-fried), Mu Xiang (Aucklandiae Radix), Qing Pi (Citri Reticulatae Pericarpium Viride), Da Fu Zi (Arecae Semen), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Ban Xia Qu (Pinelliae Fermentum, stir-fried), Ding Xiang (Caryophylli Flos), Tian Nan Xing (Arisaematis Rhizoma), Gan Jiang (Zingiberis Rhizoma, stir-fried), Mai (Tritici Vulgaris Fructus, stir-fried), Cao Guo Ren (Tsao-ko Fruit Seed) (each 1 liang), Zhi Gan Cao (Honey-fried Licorice Root) (0.5 liang).
The above herbs are ground into fine powder. Each dose is 2 qian, decocted with water, administered with fresh ginger.
Jufang Wuge Kuanchzhong San (Bureau Formula Five Ge Widening Middle Powder) treats the five types of Ge disease caused by injury to the Spleen and Stomach from the Seven Emotions (Qi Qing) and Four Qi pathogens (Si Qi), resulting in stifling fullness in the chest and diaphragm, retention of phlegm, and rebellious qi.
Qing Pi (Citri Reticulatae Pericarpium Viride), Chen Pi (Citri Reticulatae Pericarpium), Ding Xiang (Caryophylli Flos) (each 4 liang), Zhi Hou Po (Magnoliae Officinalis Cortex, processed) (1 jin), Zhi Gan Cao (Honey-fried Licorice Root) (5 liang), Bai Dou Kou (Amomi Fructus Rotundus) (1 liang), Chao Zhi He Su (Cyperi Rhizoma, stir-fried), Sha Ren (Amomi Fructus), Mu Xiang (Aucklandiae Radix) (each 3 liang).
The above herbs are ground into powder. Each dose is 2 qian, taken with ginger-salt water.
Commentary: The herbs used in the above three formulas belong to the Taiyin and Yangming meridians.
Respectful Note: Ancient formulas for treating Fan Wei (Regurgitation/Reverse Flow) mostly use aromatic, drying, and intensely hot herbs, which are not suitable as standard practice. Here, only one or two are retained for reference. Regarding Zhu Danxi's mention of herbs that nourish blood, benefit yin, moisten dryness, harmonize the Stomach, and regulate the middle, although specific formulas are not provided, they should be selected according to the pattern. Observing his theoretical stance already covers more than half of the matter.
Miscellaneous Formulas
Shao Zhen Wan (Burned Needle Pill)
(See the Children's Section for the formula)
The *Zhen Jing* (Classic of Acupuncture) states: All cases of Zhang (Distension) occur outside the Zang-Fu organs, pushing against them and expanding the chest and hypochondrium, causing the skin to swell; hence it is named "Zhang". It may also arise from Jue Qi (Rebellious Qi) accumulating below, where Ying and Wei (Nutritive and Defensive Qi) stagnate and stop, cold qi rebels upward, and true pathogenic factors attack each other. When these two qi interact and combine, Zhang (Distension) is formed.
Commentary: The discussion details the various syndromes of distension arising from the five Zang and six Fu organs; it is advisable to study the original text carefully.
The *Nei Jing* (Inner Canon) states: Various abdominal distensions and enlargements all belong to Heat. If there is abdominal fullness, distension obstructing the diaphragm, and Jue Qi rising from the hypochondrium to invade upwards, this belongs to Cold-Dampness stagnation in the Taiyin and Yangming meridians.
The *Yuan Bing Shi* (Book on the Origin of Diseases) states: Abdominal distension and enlargement, sounding like a drum when tapped, occurs because Qi belongs to Yang, and Yang transforms into heat. When heat is extreme, such manifestations occur.